Provider Demographics
NPI:1427171644
Name:ALTERNATIVE TRANSITIONS OF THE CAROLINAS, INC
Entity type:Organization
Organization Name:ALTERNATIVE TRANSITIONS OF THE CAROLINAS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MONTOYA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHRISTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-414-6740
Mailing Address - Street 1:6047 TYVOLA GLEN CIR
Mailing Address - Street 2:SUITE 216
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-6431
Mailing Address - Country:US
Mailing Address - Phone:704-414-6738
Mailing Address - Fax:704-414-6739
Practice Address - Street 1:6047 TYVOLA GLEN CIR
Practice Address - Street 2:SUITE 216
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-6431
Practice Address - Country:US
Practice Address - Phone:704-414-6738
Practice Address - Fax:704-414-6739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC020771712251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEN0829Medicaid
SC020771712Medicaid