Provider Demographics
NPI:1134206212
Name:AAA CARE AND TREATMENT, INC
Entity type:Organization
Organization Name:AAA CARE AND TREATMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:B
Authorized Official - Last Name:RUSHING
Authorized Official - Suffix:
Authorized Official - Credentials:QDDP,QMHP,QSAP
Authorized Official - Phone:704-868-2136
Mailing Address - Street 1:306 S COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-0450
Mailing Address - Country:US
Mailing Address - Phone:704-868-2136
Mailing Address - Fax:704-868-2175
Practice Address - Street 1:306 S COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-0450
Practice Address - Country:US
Practice Address - Phone:704-868-2136
Practice Address - Fax:704-868-2175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0037571041C0700X
NC5042101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003765Medicaid
NC8300361BMedicaid
NC6005472Medicaid
NC6103184Medicaid
NC3408073Medicaid
NC8300361GMedicaid
NC8300361Medicaid