Provider Demographics
NPI:1407914682
Name:WILSON COUNTY ALTERNATIVE SCHOOL
Entity Type:Organization
Organization Name:WILSON COUNTY ALTERNATIVE SCHOOL
Other - Org Name:NEW OPPORTUNITIES
Other - Org Type:Other Name
Authorized Official - Title/Position:VP - OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-243-4450
Mailing Address - Street 1:316 DOUGLAS ST S
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4916
Mailing Address - Country:US
Mailing Address - Phone:252-243-4450
Mailing Address - Fax:252-243-3077
Practice Address - Street 1:316 DOUGLAS ST S
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4916
Practice Address - Country:US
Practice Address - Phone:252-243-4450
Practice Address - Fax:252-243-3077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-098-106251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300879Medicaid