Organization
HEARTWOOD FAMILY CARE
Active
Parent organization
ALBERTA PROFESSIONAL SERVICES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALBERTA PROFESSIONAL SERVICES, INC.
Authorized official
MR. DEREK MITCHELL BS, QP (OPERATIONS MANAGER)
(336) 273-2640
Entity
Organization
Contact information
Practice address
5921 BUSH RD, BROWNS SUMMIT, NC 27214-9612
(336) 358-9287
(336) 273-6522
Mailing address
1000 REVOLUTION MILL DR, STUDIO #2, GREENSBORO, NC 27405-5082
(336) 273-2640
(336) 273-6522
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-041-152
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603003
—
NC
Enumeration date
04/23/2009
Last updated
04/23/2009
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