Provider Demographics
NPI:1417003203
Name:ALPHA OMEGA HEALTH INC
Entity Type:Organization
Organization Name:ALPHA OMEGA HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:K
Authorized Official - Last Name:HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-844-1008
Mailing Address - Street 1:5950 SIX FORKS RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-3895
Mailing Address - Country:US
Mailing Address - Phone:919-844-1008
Mailing Address - Fax:919-844-0042
Practice Address - Street 1:511 E MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-3022
Practice Address - Country:US
Practice Address - Phone:828-678-9544
Practice Address - Fax:828-682-4889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC61006394Medicaid
NC2335034AOtherMEDICARE GROUP
NC8301296BMedicaid
NC8301296QMedicaid
NC286723COtherMEDICARE - JOE
NC6111757Medicaid
NC8301296GMedicaid
NC6004036Medicaid
NC6005868Medicaid
NC8301296AMedicaid