# ALBERTA PROFESSIONAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ALBERTA PROFESSIONAL SERVICES
- **Other names:** Booth Road Group Home
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1659515559
- **Legal business name:** ALBERTA PROFESSIONAL SERVICES
- **Authorized official:** MR. DEREK MITCHELL BS, QP (OPERATIONS MANAGER)
- **Authorized official phone:** (336) 273-2640

## Contact information

- **Practice address:** 130 BOOTH RD, CHAPEL HILL, NC 27516-9643
- **Practice address phone:** (919) 967-5591
- **Practice address fax:** (336) 273-6522
- **Mailing address:** 3107 S ELM EUGENE ST, BUILDING A, GREENSBORO, NC 27406-5201
- **Mailing address phone:** (336) 273-2640
- **Mailing address fax:** (336) 273-6522

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | MHL-068-138 | NC | Yes |

## Other

- **Enumeration date:** 04/23/2009
- **Last updated:** 07/26/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7806103 | — | NC |