Basic Information
Provider Information | |||||||||
NPI: | 1841332194 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | ALTERNATIVE CARE TREATMENT SYSTEMS, INC. | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 1261 | ||||||||
Address2: |   | ||||||||
City: | FAYETTEVILLE | ||||||||
State: | NC | ||||||||
PostalCode: | 283021261 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2525229611 | ||||||||
FaxNumber: | 2525209601 | ||||||||
Practice Location | |||||||||
Address1: | 907 HAY ST | ||||||||
Address2: |   | ||||||||
City: | FAYETTEVILLE | ||||||||
State: | NC | ||||||||
PostalCode: | 283055366 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9104380939 | ||||||||
FaxNumber: | 9104380942 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 02/13/2007 | ||||||||
LastUpdateDate: | 07/12/2010 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | HEDGEPETH | ||||||||
AuthorizedOfficialFirstName: | STEVEN | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
AuthorizedOfficialTelephone: | 2525229611 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X |   |   | Y |   | Agencies | Community/Behavioral Health |   |
ID Information
ID | Type | State | Issuer | Description | 8301601 | 01 | NC | MEDICAID CIS GROUP | OTHER | 019EU | 01 | NC | BCBS | OTHER | 8301601B | 01 | NC | MEDICAID CSS ATTENDING | OTHER | 8301601V | 01 | NC | MEDICAID COMMUNITY SUPPORT TEAM | OTHER | 5905785 | 01 | NC | MEDICAID PHYSICIAN GROUP | OTHER | 6005923 | 01 | NC | MEDICAID MULTI-SPECIALITY GROUP | OTHER | 8301601G | 01 |   | MEDICAID DA ATTENDING | OTHER | 8301601H | 01 | NC | MEDICAID IIH ATTENDING | OTHER | 8301601Q | 01 | NC | MEDICAID SAIOP ATTENDING | OTHER |