Provider Demographics
NPI:1003952417
Name:ALTERNATE FAMILY CARE INC
Entity Type:Organization
Organization Name:ALTERNATE FAMILY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:954-746-5200
Mailing Address - Street 1:10001 W OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6925
Mailing Address - Country:US
Mailing Address - Phone:954-746-5200
Mailing Address - Fax:954-746-5216
Practice Address - Street 1:10001 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6925
Practice Address - Country:US
Practice Address - Phone:954-746-5200
Practice Address - Fax:954-746-5216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLR-AFC-0906-100-6322D00000X
FLR-AFC-0906-101-6322D00000X
FLR-AFC-1006-102-17323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL029582503Medicaid
FL029582508Medicaid
FL029582510Medicaid
FL029582516Medicaid
FL029582505Medicaid
FL029582500Medicaid
FL029582501Medicaid
FL029582502Medicaid
FL029582507Medicaid
FL029582504Medicaid
FL029582511Medicaid