Provider Demographics
NPI:1447473889
Name:ALTERNATIVES LIVING, INC.
Entity type:Organization
Organization Name:ALTERNATIVES LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICKEY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:ROBERSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:MSM
Authorized Official - Phone:504-400-3583
Mailing Address - Street 1:201 SAINT CHARLES AVE
Mailing Address - Street 2:STE. 2543
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70170-1000
Mailing Address - Country:US
Mailing Address - Phone:504-821-4439
Mailing Address - Fax:504-821-4775
Practice Address - Street 1:201 SAINT CHARLES AVE
Practice Address - Street 2:STE. 2543
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70170-1000
Practice Address - Country:US
Practice Address - Phone:504-821-4439
Practice Address - Fax:504-821-4775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12269251C00000X
LA12270251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1564613Medicaid
LA1564605Medicaid