Provider Demographics
NPI:1932535143
Name:SAGE ALLIANCE INC
Entity Type:Organization
Organization Name:SAGE ALLIANCE INC
Other - Org Name:SPIRIT CENTRAL INC
Other - Org Type:Other Name
Authorized Official - Title/Position:SENIOR EXECUTIVE DIRECTOR/ M.I.
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:JEANETTE
Authorized Official - Last Name:MYERS HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-791-7638
Mailing Address - Street 1:2116 WOODLAWN ST
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28083-3062
Mailing Address - Country:US
Mailing Address - Phone:704-791-7638
Mailing Address - Fax:704-933-4669
Practice Address - Street 1:2116 WOODLAWN ST
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28083-3062
Practice Address - Country:US
Practice Address - Phone:704-791-7638
Practice Address - Fax:704-933-4669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty