Provider Demographics
NPI:1568789824
Name:ALTERNATIVE THERAPEUTIC HOME CARE INC
Entity Type:Organization
Organization Name:ALTERNATIVE THERAPEUTIC HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:VERNELL WHITE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:757-748-1900
Mailing Address - Street 1:873 DOVERCOURT RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518
Mailing Address - Country:US
Mailing Address - Phone:757-748-1900
Mailing Address - Fax:
Practice Address - Street 1:427 W 37TH STREET
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508
Practice Address - Country:US
Practice Address - Phone:757-748-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA302R00000X302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization