Healthcare Provider Details

I. General information

NPI: 1982004362
Provider Name (Legal Business Name): ALTERNATIVE OPPURTUNITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2014
Last Update Date: 09/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

684 SKY VU SHOPPING CENTER HIGHWAY 412 WEST
SALEM AR
72576
US

IV. Provider business mailing address

684 SKY VU SHOPPING CENTER HIGHWAY 412 WEST
SALEM AR
72576
US

V. Phone/Fax

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

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: BILLING
Credential:
Phone: 870-793-8900