Provider Demographics
NPI:1275123226
Name:ALTERNATIVE CORRECTIONAL HEALTHCARE
Entity Type:Organization
Organization Name:ALTERNATIVE CORRECTIONAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SALLIE
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:207-523-9158
Mailing Address - Street 1:109 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-1723
Mailing Address - Country:US
Mailing Address - Phone:207-523-9158
Mailing Address - Fax:
Practice Address - Street 1:109 RIVER RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-1723
Practice Address - Country:US
Practice Address - Phone:207-523-9158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-24
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health