Healthcare Provider Details

I. General information

NPI: 1235451741
Provider Name (Legal Business Name): ALTERNATIVE OUTCOMES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2010
Last Update Date: 05/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1531 PLANTATION POINTE DR
ORLANDO FL
32824-4855
US

IV. Provider business mailing address

1531 PLANTATION POINTE DR
ORLANDO FL
32824-4855
US

V. Phone/Fax

Practice location:
  • Phone: 407-721-7755
  • Fax: 407-704-1144
Mailing address:
  • Phone: 407-721-7755
  • Fax: 407-704-1144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1062987
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number1062987
License Number StateFL

VIII. Authorized Official

Name: MR. ADRIAN DAVID DAISLEY
Title or Position: BEHAVIOR ANALYST
Credential: BCBA
Phone: 407-721-7755