Provider Demographics
NPI:1083146443
Name:ALPHACARE SUPPORT COORDINATION
Entity Type:Organization
Organization Name:ALPHACARE SUPPORT COORDINATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VANDELL
Authorized Official - Middle Name:
Authorized Official - Last Name:COBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-310-5952
Mailing Address - Street 1:7809 AIRLINE DR
Mailing Address - Street 2:STE308
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-6439
Mailing Address - Country:US
Mailing Address - Phone:504-731-3100
Mailing Address - Fax:
Practice Address - Street 1:7809 AIRLINE DR
Practice Address - Street 2:STE308
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003-6439
Practice Address - Country:US
Practice Address - Phone:504-731-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency