Provider Demographics
NPI:1639217565
Name:METRO INTEGRATED ALLIANCE
Entity Type:Organization
Organization Name:METRO INTEGRATED ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-707-3888
Mailing Address - Street 1:PO BOX 5442
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-1507
Mailing Address - Country:US
Mailing Address - Phone:704-707-3888
Mailing Address - Fax:704-707-3916
Practice Address - Street 1:1 BUFFALO AVE NW
Practice Address - Street 2:SUITE 1103
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-4417
Practice Address - Country:US
Practice Address - Phone:704-707-3888
Practice Address - Fax:704-707-3916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8700461Medicaid