Provider Demographics
NPI:1295004323
Name:A & C ALTERNATIVE CARE CORPORATION
Entity Type:Organization
Organization Name:A & C ALTERNATIVE CARE CORPORATION
Other - Org Name:A & C ALTERNATIVE CARE VB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADM. DIRECTOR QMRP
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-333-7613
Mailing Address - Street 1:317 OFFICE SQUARE LN
Mailing Address - Street 2:SUITE 101B
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3650
Mailing Address - Country:US
Mailing Address - Phone:757-333-7613
Mailing Address - Fax:757-333-7614
Practice Address - Street 1:317 OFFICE SQUARE LN
Practice Address - Street 2:SUITE 101B
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3650
Practice Address - Country:US
Practice Address - Phone:757-333-7613
Practice Address - Fax:757-333-7614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1241-03-001253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1053689943Medicaid