Provider Demographics
NPI:1497365506
Name:ALPHA RECOVERY HEALTHCARE SERVICES INC.
Entity Type:Organization
Organization Name:ALPHA RECOVERY HEALTHCARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AYOOLA
Authorized Official - Middle Name:JULIANA
Authorized Official - Last Name:OYENUGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-821-2195
Mailing Address - Street 1:2014 WHISTLING DUCK DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-7139
Mailing Address - Country:US
Mailing Address - Phone:240-821-2195
Mailing Address - Fax:
Practice Address - Street 1:9701 APOLLO DR STE 293
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-4789
Practice Address - Country:US
Practice Address - Phone:240-821-2195
Practice Address - Fax:301-390-0463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-04
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty