Provider Demographics
NPI:1285160416
Name:RESIDENTIAL ALTERNATIVES INC
Entity type:Organization
Organization Name:RESIDENTIAL ALTERNATIVES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:J
Authorized Official - Last Name:OSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:BHS
Authorized Official - Phone:248-369-8936
Mailing Address - Street 1:PO BOX 709
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48357-0709
Mailing Address - Country:US
Mailing Address - Phone:248-369-8936
Mailing Address - Fax:248-382-5327
Practice Address - Street 1:14087 PLACID DR
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442-8308
Practice Address - Country:US
Practice Address - Phone:248-369-8936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-09
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS630012426320900000X
MIAS630012519320900000X
MIAS630080974320900000X
MIAS630012774320900000X
MIAS630012764320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities