Provider Demographics
NPI:1578732475
Name:SANDHILLS ALTERNATIVE ACADEMY, LLC
Entity Type:Organization
Organization Name:SANDHILLS ALTERNATIVE ACADEMY, LLC
Other - Org Name:SANDHILLS ALTERNATIVE ACADEMY, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/QP
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:B
Authorized Official - Last Name:EASTERLING
Authorized Official - Suffix:
Authorized Official - Credentials:QP,MPA
Authorized Official - Phone:910-417-4922
Mailing Address - Street 1:503 ROCKINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-3615
Mailing Address - Country:US
Mailing Address - Phone:910-417-4922
Mailing Address - Fax:910-417-4923
Practice Address - Street 1:121 PINE NEEDLE LN
Practice Address - Street 2:
Practice Address - City:HAMLET
Practice Address - State:NC
Practice Address - Zip Code:28345-8803
Practice Address - Country:US
Practice Address - Phone:910-417-4922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL077050251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health