Provider Demographics
NPI:1770922452
Name:THERAPEUTIC ALTERNATIVES, INC.
Entity type:Organization
Organization Name:THERAPEUTIC ALTERNATIVES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BURROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-495-2700
Mailing Address - Street 1:PO BOX 814
Mailing Address - Street 2:
Mailing Address - City:RANDLEMAN
Mailing Address - State:NC
Mailing Address - Zip Code:27317-0814
Mailing Address - Country:US
Mailing Address - Phone:336-495-2700
Mailing Address - Fax:
Practice Address - Street 1:4031 HEATH DAIRY RD
Practice Address - Street 2:
Practice Address - City:RANDLEMAN
Practice Address - State:NC
Practice Address - Zip Code:27317-7487
Practice Address - Country:US
Practice Address - Phone:336-495-2748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408682Medicaid