Provider Demographics
NPI:1811042005
Name:ALTERNATE HOME CARE SPECIALIST, INC.
Entity Type:Organization
Organization Name:ALTERNATE HOME CARE SPECIALIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:BEROY
Authorized Official - Last Name:DASCO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:386-503-3133
Mailing Address - Street 1:5 BIG DIPPER LN
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-9355
Mailing Address - Country:US
Mailing Address - Phone:386-246-9756
Mailing Address - Fax:
Practice Address - Street 1:5 BIG DIPPER LN
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-9355
Practice Address - Country:US
Practice Address - Phone:386-246-9756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10729310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility