Provider Demographics
NPI:1871709402
Name:ALTERNATIVE SERVICES - CONNECTICUT, INC
Entity type:Organization
Organization Name:ALTERNATIVE SERVICES - CONNECTICUT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:D
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-537-4697
Mailing Address - Street 1:84 LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415-1134
Mailing Address - Country:US
Mailing Address - Phone:860-537-4697
Mailing Address - Fax:860-537-6257
Practice Address - Street 1:84 LINWOOD AVE
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415-1134
Practice Address - Country:US
Practice Address - Phone:860-537-4697
Practice Address - Fax:860-537-6257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTR-466311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility