Healthcare Provider Details

I. General information

NPI: 1942398839
Provider Name (Legal Business Name): ALTERNATIVE COMMUNITY RESOURCE PROGRAM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 03/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 MARKET ST
JOHNSTOWN PA
15901-1628
US

IV. Provider business mailing address

131 MARKET ST
JOHNSTOWN PA
15901-1628
US

V. Phone/Fax

Practice location:
  • Phone: 814-535-2277
  • Fax: 814-536-5431
Mailing address:
  • Phone: 814-535-2277
  • Fax: 814-536-5431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number315680
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number309250
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number315680
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number309250
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number315680
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number309250
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number324550
License Number StatePA

VIII. Authorized Official

Name: FRANK J JANAKOVIC
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 814-535-2277