Provider Demographics
NPI:1558485078
Name:ALTERNATIVE HOME CARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:ALTERNATIVE HOME CARE SOLUTIONS, LLC
Other - Org Name:CORTLAND MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-575-2317
Mailing Address - Street 1:4320 CORTLAND ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48204-1556
Mailing Address - Country:US
Mailing Address - Phone:313-491-5525
Mailing Address - Fax:313-491-5523
Practice Address - Street 1:4320 CORTLAND ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48204-1556
Practice Address - Country:US
Practice Address - Phone:313-491-5525
Practice Address - Fax:313-491-5523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities