Healthcare Provider Details

I. General information

NPI: 1689937856
Provider Name (Legal Business Name): ALTERNATIVE HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 06/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

724 YORK RD STE 2C
TOWSON MD
21204-2378
US

IV. Provider business mailing address

724 YORK RD STE 2C
TOWSON MD
21204-2378
US

V. Phone/Fax

Practice location:
  • Phone: 410-769-8094
  • Fax: 410-760-8092
Mailing address:
  • Phone: 410-769-8094
  • Fax: 410-760-8092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberR1015
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number84498
License Number StateMD

VIII. Authorized Official

Name: MRS. PACITA REGALADO ANSARI
Title or Position: PRESIDENT
Credential: BS MSN
Phone: 410-769-8094