Provider Demographics
NPI:1972503365
Name:ALTERNATIVE HEALTH SERVICES OF ST. JOSEPH INC.
Entity Type:Organization
Organization Name:ALTERNATIVE HEALTH SERVICES OF ST. JOSEPH INC.
Other - Org Name:ST. JOSEPH HOMECARE AND HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-907-1600
Mailing Address - Street 1:PO BOX 934
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04402-0934
Mailing Address - Country:US
Mailing Address - Phone:413-406-6078
Mailing Address - Fax:
Practice Address - Street 1:900 BROADWAY BLDG 4
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-1900
Practice Address - Country:US
Practice Address - Phone:207-907-1810
Practice Address - Fax:207-907-1928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-28
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME38335251E00000X
ME36863251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME117630001Medicaid
ME117630000Medicaid
ME117630000Medicaid
ME201504Medicare ID - Type UnspecifiedHOSPICE
ME117630000Medicaid