Basic Information
| Provider Information | |||||||||
| NPI: | 1316139488 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALTERNATE SOLUTIONS HOMECARE 5, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1050 FORRER BLVD | ||||||||
| Address2: | |||||||||
| City: | KETTERING | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454201472 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372981111 | ||||||||
| FaxNumber: | 9372987210 | ||||||||
| Practice Location | |||||||||
| Address1: | 22021 BROOKPARK RD STE 143 | ||||||||
| Address2: | |||||||||
| City: | FAIRVIEW PARK | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441263100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2168617422 | ||||||||
| FaxNumber: | 8882676051 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2007 | ||||||||
| LastUpdateDate: | 11/30/2020 | ||||||||
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| AuthorizedOfficialLastName: | KLOPSCH | ||||||||
| AuthorizedOfficialFirstName: | DEBORAH | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP LEGAL AFFAIRS | ||||||||
| AuthorizedOfficialTelephone: | 9372991111 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 11/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 3137706 | 05 | OH | MEDICAID |