Provider Demographics
NPI:1477725000
Name:ALTERNATIVE FAMILY LIVIN INC
Entity Type:Organization
Organization Name:ALTERNATIVE FAMILY LIVIN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LANGSTON
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:828-255-4453
Mailing Address - Street 1:303 OLD HIGHWAY 20
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER
Mailing Address - State:NC
Mailing Address - Zip Code:28701-9113
Mailing Address - Country:US
Mailing Address - Phone:828-255-4453
Mailing Address - Fax:828-252-5130
Practice Address - Street 1:303 OLD HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:ALEXANDER
Practice Address - State:NC
Practice Address - Zip Code:28701-9113
Practice Address - Country:US
Practice Address - Phone:828-255-4453
Practice Address - Fax:828-252-5130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418517Medicaid