Provider Demographics
NPI:1356313092
Name:ALTERNATIVE CARE SERVICES
Entity Type:Organization
Organization Name:ALTERNATIVE CARE SERVICES
Other - Org Name:MEMORIAL HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DOLAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:DALPOAS
Authorized Official - Suffix:
Authorized Official - Credentials:FACHE
Authorized Official - Phone:217-788-3157
Mailing Address - Street 1:644 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62702-5222
Mailing Address - Country:US
Mailing Address - Phone:217-788-4663
Mailing Address - Fax:217-788-5597
Practice Address - Street 1:3132 OLD JACKSONVILLE RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-7400
Practice Address - Country:US
Practice Address - Phone:217-862-0001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========005Medicaid
IL=========005Medicaid