Provider Demographics
NPI:1073848867
Name:ALPHA GROUP ADMINISTRATORS, INC.
Entity Type:Organization
Organization Name:ALPHA GROUP ADMINISTRATORS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGETT
Authorized Official - Middle Name:
Authorized Official - Last Name:LINNEBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-375-8553
Mailing Address - Street 1:11070 N 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4705
Mailing Address - Country:US
Mailing Address - Phone:602-375-8553
Mailing Address - Fax:602-375-0057
Practice Address - Street 1:11070 N 24TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4705
Practice Address - Country:US
Practice Address - Phone:602-375-8553
Practice Address - Fax:602-375-0057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-12
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251C00000X, 251S00000X, 253Z00000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities