| Alliance Community Transition Group Llc | |
|
227 W 4th St Ste 308 Charlotte NC 28202-1545 | |
| (919) 888-6164 | |
| Not Available |
| Full Name | Alliance Community Transition Group Llc |
|---|---|
| Speciality | Social Worker |
| Location | 227 W 4th St Ste 308, Charlotte, North Carolina |
| Authorized Official Name and Position | Ervin Davis (OWNER) |
| Authorized Official Contact | 9198886164 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Community Transition Group Llc 227 W 4th St Ste 308 Charlotte NC 28202-1545 Ph: (919) 888-6164 | Alliance Community Transition Group Llc 227 W 4th St Ste 308 Charlotte NC 28202-1545 Ph: (919) 888-6164 |
| NPI Number | 1427650795 |
|---|---|
| Provider Enumeration Date | 11/12/2020 |
| Last Update Date | 11/12/2020 |
| Certification Date | 11/12/2020 |
| Medicare PECOS PAC ID | 6608248513 |
|---|---|
| Medicare Enrollment ID | O20230202000157 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427650795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Elise Desjardins Stanford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104412493 PECOS PAC ID: 2567862337 Enrollment ID: I20210616000153 |
| Provider Name | Ervin Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548708944 PECOS PAC ID: 7416329321 Enrollment ID: I20230202000205 |
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