Organization
COMMUNITY BASED LEARNING ALTERNATIVES CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANET M WISE (EXECUTIVE DIRECTOR)
(919) 989-1786
Entity
Organization
Contact information
Practice address
212 BRIDGE ST, SMITHFIELD, NC 27577-3963
(919) 938-4344
(919) 938-4342
Mailing address
1300 W MARKET ST, SMITHFIELD, NC 27577-3339
(919) 989-1786
(919) 989-1791
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL 051 161
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5901780
—
NC
05
—
6005614
—
NC
05
—
6600860
—
NC
05
—
8301075
—
NC
05
—
8700356
—
NC
Enumeration date
09/12/2007
Last updated
09/12/2007
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