MEDICARE: ALTERNATIVE OPPURTUNITIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1710387584
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTERNATIVE OPPURTUNITIES

Provider Business Mailing Address
First Line	:	2526 HIGHWAY 65 S
Second Line	:	STE 202
City	:	CLINTON
State	:	AR
Zip	:	72031-6657
Country	:	US
Telephone Number	:	870-793-8900
Fax Number	:	870-793-8959

Provider Business Practice Location Address
First Line	:	2526 HIGHWAY 65 S
Second Line	:	STE 202
City	:	CLINTON
State	:	AR
Zip	:	72031-6657
Country	:	US
Telephone Number	:	870-793-8900
Fax Number	:	870-793-8959

Authorized Official
Title or Position	:	QC
Name	:	JEANNE BROSIUS
Credential	:
Telephone Number	:	870-793-8900

Provider Enumeration Date	:	08/29/2014
Last Update Date	:	08/29/2014

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