Provider Demographics
NPI:1033624176
Name:ALPHA & OMEGA COMMUNITY SERVICES CORPORATION
Entity Type:Organization
Organization Name:ALPHA & OMEGA COMMUNITY SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BLOWE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:240-421-4105
Mailing Address - Street 1:1643 W VIRGINIA AVE NE APT 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-2360
Mailing Address - Country:US
Mailing Address - Phone:240-421-4105
Mailing Address - Fax:
Practice Address - Street 1:1643 W VIRGINIA AVE NE APT 2
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-2360
Practice Address - Country:US
Practice Address - Phone:240-421-4105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-12
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable