Healthcare Provider Details

I. General information

NPI: 1629478490
Provider Name (Legal Business Name): ALTERNATIVE OPPURTUNITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2014
Last Update Date: 08/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 HIGHWAY 5
ROSE BUD AR
72137-9721
US

IV. Provider business mailing address

931 HIGHWAY 5
ROSE BUD AR
72137-9721
US

V. Phone/Fax

Practice location:
  • Phone: 870-793-8900
  • Fax: 870-793-8959
Mailing address:
  • Phone: 870-793-8900
  • Fax: 870-793-8959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JEANNE BROSIUS
Title or Position: QC
Credential:
Phone: 870-793-8900