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General NPI Number Information
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NPI Number | 1285160416
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Entity Type | Organization
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Legal Business Name | RESIDENTIAL ALTERNATIVES INC
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Dates
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Enumeration Date | 05/09/2017
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Last Update Date | 05/09/2017
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Provider Practice Location Address
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Address Line | 14087 PLACID DR
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City | HOLLY
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State | MI
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Zip | 48442-8308
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Country | US
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Telephone | 248-369-8936
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 709
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City | HIGHLAND
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State | MI
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Zip | 48357-0709
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Country | US
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Telephone | 248-369-8936
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Fax | 248-382-5327
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Authorized Official
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Title or Position | PRESIDENT
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Name | RENEE J OSTROM
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Credential | BHS
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Telephone | 248-369-8936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | AS630012426
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | AS630012519
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | AS630080974
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | AS630012774
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | AS630012764
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License Number State | MI
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