Provider Demographics
NPI:1477056554
Name:ALPHA COMMUNITY LIVING ARRANGEMENT LLC
Entity Type:Organization
Organization Name:ALPHA COMMUNITY LIVING ARRANGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:BYNOE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:412-969-3363
Mailing Address - Street 1:365 GOLDEN GATE DR
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:PA
Mailing Address - Zip Code:15147-2609
Mailing Address - Country:US
Mailing Address - Phone:412-969-3363
Mailing Address - Fax:
Practice Address - Street 1:365 GOLDEN GATE DR
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:PA
Practice Address - Zip Code:15147-2609
Practice Address - Country:US
Practice Address - Phone:412-969-3363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty