Provider Demographics
NPI:1043262850
Name:ALPHA REHABILITATION, LLC
Entity Type:Organization
Organization Name:ALPHA REHABILITATION, LLC
Other - Org Name:ALPHA REHABILITATION, PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-447-5522
Mailing Address - Street 1:290 NICKEL ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-2183
Mailing Address - Country:US
Mailing Address - Phone:303-460-9151
Mailing Address - Fax:303-460-7443
Practice Address - Street 1:290 NICKEL ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-2183
Practice Address - Country:US
Practice Address - Phone:303-460-9151
Practice Address - Fax:303-460-7443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC803859Medicare PIN