Provider Demographics
NPI:1356840920
Name:ALPHA CARE - HOME & HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:ALPHA CARE - HOME & HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EGBO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, NP
Authorized Official - Phone:386-275-2735
Mailing Address - Street 1:101 N WOODLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-4245
Mailing Address - Country:US
Mailing Address - Phone:386-275-2735
Mailing Address - Fax:386-469-9199
Practice Address - Street 1:101 N WOODLAND BLVD
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-4245
Practice Address - Country:US
Practice Address - Phone:386-275-2735
Practice Address - Fax:386-469-9199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health