Provider Demographics
NPI:1942559075
Name:ALTERNATIVE COMMUNITY PENALTIES PROGRAM, INC.
Entity Type:Organization
Organization Name:ALTERNATIVE COMMUNITY PENALTIES PROGRAM, INC.
Other - Org Name:THE RESTORATIVE JUSTICE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:LANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-671-1030
Mailing Address - Street 1:410 W FRANKLIN BLVD
Mailing Address - Street 2:SUITE 20
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-2807
Mailing Address - Country:US
Mailing Address - Phone:704-671-1030
Mailing Address - Fax:704-869-7336
Practice Address - Street 1:410 W FRANKLIN BLVD
Practice Address - Street 2:SUITE 20
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28052-2807
Practice Address - Country:US
Practice Address - Phone:704-671-1030
Practice Address - Fax:704-869-7336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL# 036 106251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health