Provider Demographics
NPI:1811528920
Name:ALTERNATIVE RESIDENTIAL CARE
Entity type:Organization
Organization Name:ALTERNATIVE RESIDENTIAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRISON
Authorized Official - Middle Name:KELVIN
Authorized Official - Last Name:DEAH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:207-321-8600
Mailing Address - Street 1:14 JOES RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04062-4515
Mailing Address - Country:US
Mailing Address - Phone:207-321-8600
Mailing Address - Fax:
Practice Address - Street 1:14 JOES RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-4515
Practice Address - Country:US
Practice Address - Phone:207-321-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities