Provider Demographics
NPI:1033408018
Name:ALPHA 1 HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:ALPHA 1 HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/RN
Authorized Official - Prefix:MRS
Authorized Official - First Name:SCHVON
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:BUSEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:229-296-8478
Mailing Address - Street 1:104 PINE ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-3184
Mailing Address - Country:US
Mailing Address - Phone:229-296-8478
Mailing Address - Fax:229-299-2909
Practice Address - Street 1:104 PINE ARBOR DR
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763-3184
Practice Address - Country:US
Practice Address - Phone:229-296-8478
Practice Address - Fax:229-299-2909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA088R0560251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care