1114152089 NPI number — ALTERNATIVE SERVICES-NE, INC.

Table of content: (NPI 1114152089)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114152089 NPI number — ALTERNATIVE SERVICES-NE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALTERNATIVE SERVICES-NE, 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:
Provider Other Organization Name Type Code:
6
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:
1114152089
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/17/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1567 LISBON ST
Provider Second Line Business Mailing Address:
SUITE 2
Provider Business Mailing Address City Name:
LEWISTON
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04240-3545
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-777-1107
Provider Business Mailing Address Fax Number:
207-777-1605

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1567 LISBON ST
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
LEWISTON
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04240-3545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-777-1107
Provider Business Practice Location Address Fax Number:
207-777-1605
Provider Enumeration Date:
05/21/2009

Additional Information

Authorized Official

Authorized Official Last Name:
VELEZ
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
860-399-7262

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , with the licence number:  219501 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X , with the licence number: 219501 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 320800000X , with the licence number: 219501 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 170010100 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 432786100 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 170010000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".




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