Healthcare Provider Details

I. General information

NPI: 1851762223
Provider Name (Legal Business Name): ALTERNATIVE SUPPORT INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2015
Last Update Date: 03/01/2021
Certification Date: 03/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8933 E UNION AVE STE 212
GREENWOOD VILLAGE CO
80111-1357
US

IV. Provider business mailing address

8933 E UNION AVE STE 212
GREENWOOD VILLAGE CO
80111-1357
US

V. Phone/Fax

Practice location:
  • Phone: 303-993-5464
  • Fax: 303-993-5522
Mailing address:
  • Phone: 303-993-5464
  • Fax: 303-993-5522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number37985825
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARTIN LAWRENCE
Title or Position: EXECUTIVE DIRECTOR
Credential: CEO
Phone: 303-993-5464