Provider Demographics
NPI:1548722549
Name:THE ALTERNATIVE LIVING GROUP, INC.
Entity type:Organization
Organization Name:THE ALTERNATIVE LIVING GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-374-0053
Mailing Address - Street 1:500 NEW KARNER ROAD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205
Mailing Address - Country:US
Mailing Address - Phone:518-374-0053
Mailing Address - Fax:518-374-4811
Practice Address - Street 1:500 NEW KARNER ROAD
Practice Address - Street 2:SUITE 3
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205
Practice Address - Country:US
Practice Address - Phone:518-374-0053
Practice Address - Fax:518-374-4811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02249943Medicaid
NY03043923Medicaid
NY03418206Medicaid