Provider Demographics
NPI:1023204393
Name:ALTERNATIVE LIFE SOLUTIONS INC.
Entity Type:Organization
Organization Name:ALTERNATIVE LIFE SOLUTIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMIA
Authorized Official - Middle Name:LASHUN
Authorized Official - Last Name:BRANTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-527-1741
Mailing Address - Street 1:854 DURWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-1854
Mailing Address - Country:US
Mailing Address - Phone:910-527-1741
Mailing Address - Fax:910-778-7154
Practice Address - Street 1:854 DURWOOD DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-1854
Practice Address - Country:US
Practice Address - Phone:910-527-1741
Practice Address - Fax:910-778-7154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization