Provider Demographics
NPI:1033942123
Name:UNIVERSAL ALTERNATIVES, LLC.
Entity type:Organization
Organization Name:UNIVERSAL ALTERNATIVES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SIGNAL
Authorized Official - Middle Name:DIYMOKE
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-651-1841
Mailing Address - Street 1:10828 GRAVELLY LAKE DR SW STE 106
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-1300
Mailing Address - Country:US
Mailing Address - Phone:253-651-1841
Mailing Address - Fax:
Practice Address - Street 1:10828 GRAVELLY LAKE DR SW STE 106
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-1300
Practice Address - Country:US
Practice Address - Phone:253-651-1841
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children