Provider Demographics
NPI:1013170638
Name:COMMUNITY ALTERNATIVES INC.
Entity Type:Organization
Organization Name:COMMUNITY ALTERNATIVES INC.
Other - Org Name:COMMUNITY CHOICES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, QUALITY & SERVICE INTEGRATION
Authorized Official - Prefix:
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FULK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-533-0166
Mailing Address - Street 1:2401 SARDIS RD N STE 120
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-7722
Mailing Address - Country:US
Mailing Address - Phone:704-336-4844
Mailing Address - Fax:
Practice Address - Street 1:2401 SARDIS R. N. STE 120
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-7722
Practice Address - Country:US
Practice Address - Phone:704-336-4844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL060441251S00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300424Medicaid
NC8300424GMedicaid
NC8300424PMedicaid
NC6005632Medicaid
NC8300424BMedicaid
NC8300424QMedicaid