Organization
ALTERNATIVE LIFESKILLS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA BROCK REGISTERED NURSE MAS (EXECUTIVE DIRECTOR)
(606) 487-1863
Entity
Organization
Contact information
Practice address
59 E MAIN ST, HAZARD, KY 41701-1938
(606) 487-1863
Mailing address
PO BOX 1418, HAZARD, KY 41702-1418
(606) 487-1863
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385H00000X
Respite Care
—
—
385HR2050X
Respite Care Camp
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
10/07/2007
Last updated
10/07/2007
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