Basic Information
| Provider Information | |||||||||
| NPI: | 1558487421 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALTERNATIVE CARE TREATMENTS SYSTEMS, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1261 | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283021261 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197344440 | ||||||||
| FaxNumber: | 9197344550 | ||||||||
| Practice Location | |||||||||
| Address1: | 139-B CENTER STREET | ||||||||
| Address2: | |||||||||
| City: | GOLDSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197344440 | ||||||||
| FaxNumber: | 9197344550 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | WRIGHT | ||||||||
| AuthorizedOfficialFirstName: | MICHELLE | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 9108263694 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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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 | 8301599A | 05 | NC | MEDICAID |