Booth Road Group Home

LBN: Alberta Professional Services
Booth Road Group Home is an health care organization with primary practice located at 130 Booth Rd , Chapel Hill NC 27516-9643. The organization recently has only one registered license in Residential Treatment Facilities / Psychiatric Residential Treatment Facility, which is considered as the primary health care specialty. Alberta Professional Services can be contacted via phone (919) 967-5591, or through Mitchell, Derek via phone (336) 273-2640.

Contact Information

Primary practice address
130 Booth Rd Chapel Hill NC 27516-9643
Fax: (336) 273-6522
Website:
Authorized official contact:
Name: Mitchell, Derek BS, QP

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Psychiatric Residential Treatment Facility 323P00000X MHL-068-138 North Carolina

Profile Details

NPI number 1659515559
LBN Legal business name Alberta Professional Services
DBA Doing business as Booth Road Group Home
Authorized official Mitchell, Derek BS, QP
Entity Organization
Organization subpart 1 Yes
Enumeration date Apr 23rd, 2009
Last updated Jul 26th, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659515559 NPPES
North Carolina MEDICAID 7806103

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