Provider Demographics
NPI:1003028499
Name:ALTERNATIVE LIVING SOLUTIONS
Entity Type:Organization
Organization Name:ALTERNATIVE LIVING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-815-8484
Mailing Address - Street 1:2218 KIWI CIR
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84118-1770
Mailing Address - Country:US
Mailing Address - Phone:801-815-8484
Mailing Address - Fax:801-965-9356
Practice Address - Street 1:2218 KIWI CIR
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84118-1770
Practice Address - Country:US
Practice Address - Phone:801-815-8484
Practice Address - Fax:801-965-9356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-05
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5127251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services