Healthcare Provider Details

I. General information

NPI: 1063910081
Provider Name (Legal Business Name): ALTERNATIVE EDUCATION SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2018
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13430 N SCOTTSDALE RD STE 206
SCOTTSDALE AZ
85254-4058
US

IV. Provider business mailing address

13430 N SCOTTSDALE RD STE 206
SCOTTSDALE AZ
85254-4058
US

V. Phone/Fax

Practice location:
  • Phone: 480-809-6230
  • Fax:
Mailing address:
  • Phone: 480-809-6230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License NumberOTC8517
License Number StateAZ

VIII. Authorized Official

Name: MR. MICHEL DANIEL ROTH
Title or Position: CEO
Credential: ESQ
Phone: 480-809-6230