Provider Demographics
NPI:1366632382
Name:THERAPEUTIC ALTERNATIVES, INC
Entity Type:Organization
Organization Name:THERAPEUTIC ALTERNATIVES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-495-2700
Mailing Address - Street 1:PO BOX 814
Mailing Address - Street 2:
Mailing Address - City:RANDLEMAN
Mailing Address - State:NC
Mailing Address - Zip Code:27317-0814
Mailing Address - Country:US
Mailing Address - Phone:336-495-2700
Mailing Address - Fax:336-495-5552
Practice Address - Street 1:962 S FAYETTEVILLE ST STE A
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-6592
Practice Address - Country:US
Practice Address - Phone:336-626-1700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8302919Medicaid
NC8300269FMedicaid
NC8302475Medicaid
NC8302919FMedicaid
NC8302475FMedicaid