Provider Demographics
NPI:1922304377
Name:HEARTFELT ALTERNATIVES, INC
Entity Type:Organization
Organization Name:HEARTFELT ALTERNATIVES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TABATHA
Authorized Official - Middle Name:EVA
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:PLCSW
Authorized Official - Phone:919-844-7770
Mailing Address - Street 1:1100 LOGGER CT
Mailing Address - Street 2:SUITE C100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-8525
Mailing Address - Country:US
Mailing Address - Phone:919-844-7770
Mailing Address - Fax:919-844-7771
Practice Address - Street 1:1100 LOGGER CT
Practice Address - Street 2:SUITE C100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-8525
Practice Address - Country:US
Practice Address - Phone:919-844-7770
Practice Address - Fax:919-844-7771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8703187Medicaid