| NPI | 1912137530 |
|---|---|
| Doing Business As | ALTERNATIVE CONCEPT CARE SERVICES MONROE |
| Entity Type | Organization |
| Authorized Contact | WAYNE PATRICK WALLACE Administratror 318-388-2203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: LA SIL 20187) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2009-07-16 |