Provider Demographics
NPI:1962681924
Name:MADISON COMMUNITY ALTERNATIVES, INC.
Entity Type:Organization
Organization Name:MADISON COMMUNITY ALTERNATIVES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BETTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-392-8775
Mailing Address - Street 1:PO BOX 13245
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27415-3245
Mailing Address - Country:US
Mailing Address - Phone:336-392-8775
Mailing Address - Fax:336-854-4452
Practice Address - Street 1:148 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:NC
Practice Address - Zip Code:27253-2808
Practice Address - Country:US
Practice Address - Phone:336-392-8775
Practice Address - Fax:336-854-4452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2009-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysisGroup - Multi-Specialty