Provider Demographics
NPI:1649579830
Name:HAB & ASSOCIATE ALTERNATIVE SOLUTIONS LLC
Entity Type:Organization
Organization Name:HAB & ASSOCIATE ALTERNATIVE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:RICHARDSON
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-309-3650
Mailing Address - Street 1:8930 SIBBALD RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-1662
Mailing Address - Country:US
Mailing Address - Phone:904-309-3650
Mailing Address - Fax:
Practice Address - Street 1:8930 SIBBALD RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-1662
Practice Address - Country:US
Practice Address - Phone:904-309-3650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL682842698Medicaid
FL682842696Medicaid