Organization
ALAMANCE ACADEMY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MOLLISSIE LAURA ANN PETERSON (DIRECTOR OF OPERATION)
(336) 437-4382
Entity
Organization
Contact information
Practice address
1522 VAUGHN RD, BURLINGTON, NC 27217-2871
(336) 350-8169
Mailing address
605 S CHURCH ST, BURLINGTON, NC 27215-3879
(336) 437-4382
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
NC
363A00000X
Physician Assistant
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
03/25/2008
Last updated
05/06/2020
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