Provider Demographics
NPI:1851762223
Name:ALTERNATIVE SUPPORT INCORPORATED
Entity Type:Organization
Organization Name:ALTERNATIVE SUPPORT INCORPORATED
Other - Org Name:ALTERNATIVE SUPPORT INCORPORATED
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:303-993-5464
Mailing Address - Street 1:8933 E UNION AVE STE 212
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1357
Mailing Address - Country:US
Mailing Address - Phone:303-993-5464
Mailing Address - Fax:303-993-5522
Practice Address - Street 1:8933 E UNION AVE STE 212
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1357
Practice Address - Country:US
Practice Address - Phone:303-993-5464
Practice Address - Fax:303-993-5522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-12
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37985825251C00000X
373H00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Single Specialty
No373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO37985825Medicaid