Provider Demographics
NPI:1629125208
Name:ALTERNATIVE ENTERPRISES, INC.
Entity Type:Organization
Organization Name:ALTERNATIVE ENTERPRISES, INC.
Other - Org Name:ALTERNATIVE COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:O'DONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:618-549-6984
Mailing Address - Street 1:606 EASTGATE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901-3304
Mailing Address - Country:US
Mailing Address - Phone:618-549-6984
Mailing Address - Fax:618-549-9614
Practice Address - Street 1:606 EASTGATE ST
Practice Address - Street 2:SUITE A
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-3304
Practice Address - Country:US
Practice Address - Phone:618-549-6984
Practice Address - Fax:618-549-9614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1630029Medicare UPIN
IL531560Medicare ID - Type UnspecifiedPROVIDER NUMBER