Healthcare Provider Details

I. General information

NPI: 1821328279
Provider Name (Legal Business Name): ALTERNATIVE SPLUTIONS FOR YOUTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2010
Last Update Date: 01/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5104 SALIMA ST
CLINTON MD
20735-3659
US

IV. Provider business mailing address

1301 LENFANT SQ SE
WASHINGTON DC
20020-6724
US

V. Phone/Fax

Practice location:
  • Phone: 240-244-5399
  • Fax:
Mailing address:
  • Phone: 202-584-1244
  • Fax: 202-584-1243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License NumberPRC799
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. PAULETTE SCOTT
Title or Position: DIRECTOR OUT PATIENT
Credential: LICSW
Phone: 202-584-1244