Provider Demographics
NPI:1013171321
Name:ALTERNATE PATHS
Entity Type:Organization
Organization Name:ALTERNATE PATHS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOHNNIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:404-358-4076
Mailing Address - Street 1:990 MOUNT ZION RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30054-4023
Mailing Address - Country:US
Mailing Address - Phone:404-358-4076
Mailing Address - Fax:770-358-5017
Practice Address - Street 1:990 MOUNT ZION RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:GA
Practice Address - Zip Code:30054-4023
Practice Address - Country:US
Practice Address - Phone:404-358-4076
Practice Address - Fax:770-358-5017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251S00000X251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health