Basic Information
| Provider Information | |||||||||
| NPI: | 1184839151 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VOCA CORP OF NORTH CAROLINA | ||||||||
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| OtherOrganizationName: | COMMUNITY ALTERNATIVES NORTH CAROLINA - I | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 805 N WHITTINGTON PKWY STE 400 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402225186 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008660860 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1200 NAVAHO DR | ||||||||
| Address2: | SUITE N | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9193871011 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2007 | ||||||||
| LastUpdateDate: | 10/10/2022 | ||||||||
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| AuthorizedOfficialLastName: | WHOBREY | ||||||||
| AuthorizedOfficialFirstName: | TIMOTHY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PROVIDER ENROLLMENT | ||||||||
| AuthorizedOfficialTelephone: | 5026307249 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 10/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | N | Agencies | Case Management | 251C00000X | N | Agencies | Day Training, Developmentally Disabled Services | 251J00000X | N | Agencies | Nursing Care | 251S00000X | N | Agencies | Community/Behavioral Health | 253Z00000X | N | Agencies | In Home Supportive Care | 315P00000X | N | Nursing & Custodial Care Facilities | Intermediate Care Facility, Mentally Retarded | 320900000X | Y | Residential Treatment Facilities | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
ID Information
| ID | Type | State | Issuer | Description | 3408795 | 05 | NC | MEDICAID |