1801069463 NPI number — ALTERNATIVE OPTIONS COUNSELING & WELLNESS CENTER INC

Table of content: (NPI 1801069463)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801069463 NPI number — ALTERNATIVE OPTIONS COUNSELING & WELLNESS CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALTERNATIVE OPTIONS COUNSELING & WELLNESS CENTER INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
JANET M ISBELL
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801069463
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/28/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4585 WASHINGTON ST
Provider Second Line Business Mailing Address:
SUITE A4
Provider Business Mailing Address City Name:
FLORISSANT
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63033-5858
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-837-0000
Provider Business Mailing Address Fax Number:
314-837-0002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4585 WASHINGTON ST
Provider Second Line Business Practice Location Address:
SUITE A4
Provider Business Practice Location Address City Name:
FLORISSANT
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63033-5858
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-837-0000
Provider Business Practice Location Address Fax Number:
314-837-0002
Provider Enumeration Date:
04/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
ISBELL
Authorized Official First Name:
JANET
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
314-837-0000

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1770717928 . This is a "NPI" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 027104 . This is a "VMC" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 027057 . This is a "VMC" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1780658971 . This is a "NPI" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 224412 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1780658971 . This is a "MH NET" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 212010 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 497505800 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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