Provider Demographics
NPI:1407179898
Name:ALTERNATIVE COMMUNITY RESOURCE PROGRAM
Entity Type:Organization
Organization Name:ALTERNATIVE COMMUNITY RESOURCE PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:JANAKOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-535-2277
Mailing Address - Street 1:131 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15901-1628
Mailing Address - Country:US
Mailing Address - Phone:814-535-2277
Mailing Address - Fax:814-539-0475
Practice Address - Street 1:3010 7TH AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-1906
Practice Address - Country:US
Practice Address - Phone:814-942-9425
Practice Address - Fax:814-942-9725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA315680251B00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100732328Medicaid