Provider Demographics
NPI:1376811968
Name:ALPHA CARE LTD.
Entity Type:Organization
Organization Name:ALPHA CARE LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:ROBY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:440-225-8402
Mailing Address - Street 1:12590 BAUMHART RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-9773
Mailing Address - Country:US
Mailing Address - Phone:440-225-8402
Mailing Address - Fax:
Practice Address - Street 1:205 W 20TH ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-3779
Practice Address - Country:US
Practice Address - Phone:440-244-2333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2895247261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2895247Medicaid
OH4702094OtherDODD CONTRACTOR NUMBER