Provider Demographics
NPI:1205858461
Name:ALPHA COMMUNITY SERVICES
Entity Type:Organization
Organization Name:ALPHA COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRUCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-574-2029
Mailing Address - Street 1:PO BOX 532
Mailing Address - Street 2:717 INDEPENDENCE BLVD, SUITE 209
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455
Mailing Address - Country:US
Mailing Address - Phone:757-574-2029
Mailing Address - Fax:757-233-3924
Practice Address - Street 1:717 INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 209
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-0532
Practice Address - Country:US
Practice Address - Phone:757-574-2029
Practice Address - Fax:757-233-3924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA699-01-001320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities