Basic Information
Provider Information
NPI: 1841505013
EntityType: 2
ReplacementNPI:  
OrganizationName: FAMILY ALTERNATIVES, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
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Mailing Information
Address1: 103 N. ELM STREET
Address2:  
City: LUMBERTON
State: NC
PostalCode: 283586541
CountryCode: US
TelephoneNumber: 9107396624
FaxNumber: 9107396781
Practice Location
Address1: 1407 E 5TH ST
Address2:  
City: LUMBERTON
State: NC
PostalCode: 283586007
CountryCode: US
TelephoneNumber: 9107391468
FaxNumber: 9107396134
Other Information
ProviderEnumerationDate: 08/12/2010
LastUpdateDate: 08/12/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: OXENDINE
AuthorizedOfficialFirstName: LAVERN
AuthorizedOfficialMiddleName: S.
AuthorizedOfficialTitleorPosition: DIRECTOR/CEO
AuthorizedOfficialTelephone: 9107396624
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MSW
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251B00000X  Y AgenciesCase Management 

No ID Information.


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