Provider Demographics
NPI:1407153026
Name:ALTERNATIVE TRANSITIONS OF THE CAROLINAS
Entity Type:Organization
Organization Name:ALTERNATIVE TRANSITIONS OF THE CAROLINAS
Other - Org Name:ALTERNATIVE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AGENCY DIRECTOR/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONTOYA
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-414-6738
Mailing Address - Street 1:6047 TYVOLA GLEN CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-6431
Mailing Address - Country:US
Mailing Address - Phone:704-414-6738
Mailing Address - Fax:704-414-6739
Practice Address - Street 1:6047 TYVOLA GLEN CIR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-6431
Practice Address - Country:US
Practice Address - Phone:704-414-6738
Practice Address - Fax:704-414-6739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-16
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3548251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601611Medicaid