Provider Demographics
NPI:1659025120
Name:WEST&GRACIE ALTERNATIVE SOLUTIONS LLC
Entity Type:Organization
Organization Name:WEST&GRACIE ALTERNATIVE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAGLENYA
Authorized Official - Middle Name:
Authorized Official - Last Name:DANTZLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-658-7507
Mailing Address - Street 1:2304 WINGATE RD UNIT 48141
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28331-8929
Mailing Address - Country:US
Mailing Address - Phone:910-977-7260
Mailing Address - Fax:
Practice Address - Street 1:4030 WAKE FOREST RD STE 349
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-0010
Practice Address - Country:US
Practice Address - Phone:910-977-7260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DREAM BIG ALTERNATIVE FOUNDATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children