Provider Demographics
NPI:1790208650
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:814-536-0475
Practice Address - Street 1:119 WALNUT ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15901-1625
Practice Address - Country:US
Practice Address - Phone:814-534-0745
Practice Address - Fax:814-536-5431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-24
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3056802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty