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Organization

COMMUNITY TREATMENT ALTERNATIVES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. REGINA DEPASS (EXECUTIVE DIRECTOR)
(704) 323-9266
Entity
Organization

Contact information

Practice address
2005 BREEZEWOOD DR, CHARLOTTE, NC 28262-1423
(704) 323-9266
Mailing address
PO BOX 215, MATTHEWS, NC 28106-0215
(704) 323-9266

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
060-739
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL#060-739
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6603933
NC
Enumeration date
01/26/2007
Last updated
06/30/2021
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