Provider Demographics
NPI:1659543668
Name:ALTERNATIVE COMMUNITY RESOURCE PROGRAM INC
Entity Type:Organization
Organization Name:ALTERNATIVE COMMUNITY RESOURCE PROGRAM INC
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:
Practice Address - Street 1:3759 BUSINESS ROUTE 220
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:PA
Practice Address - Zip Code:15522
Practice Address - Country:US
Practice Address - Phone:814-623-1212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALTERNATIVE COMMUNITY RESOURCE PROGRAM INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-31
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA324550251S00000X
PA315680251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1422061OtherHIGHMARK BC/BS
PA2051597OtherKEYSTONE HEALTH PLAN WEST
PA1007323280035Medicaid
2051620OtherKEYSTONE HEALTH PLAN WEST
PA067243Medicare PIN
PA067243Medicare PIN