Basic Information
| Provider Information | |||||||||
| NPI: | 1356490569 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALTERNATIVE CARE TREATMENT SYSTEMS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1261 | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283021261 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2525229611 | ||||||||
| FaxNumber: | 2525209601 | ||||||||
| Practice Location | |||||||||
| Address1: | 139 B N CENTER STREET | ||||||||
| Address2: | |||||||||
| City: | GOLDSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275304828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197344440 | ||||||||
| FaxNumber: | 2522080149 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2007 | ||||||||
| LastUpdateDate: | 05/30/2013 | ||||||||
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| AuthorizedOfficialLastName: | HEDGEPETH | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9108263694 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 019EU | 01 | NC | BCBS | OTHER | 5904864 | 01 | NC | MEDICAID PHYSICIAN GROUP | OTHER | 8301602G | 01 | MEDICAID DA ATTENDING | OTHER | 8301602H | 01 | MEDICAID IIH ATTENDING | OTHER | 8301599A | 05 | NC | MEDICAID | 8301602B | 01 | MEDICAID CSS ATTENDING | OTHER | 6005967 | 01 | NC | MEDICAID MULTI-SPECIALTY GROUP | OTHER | 8301602 | 05 | NC | MEDICAID |