Provider Demographics
NPI:1518245265
Name:ALPHA AND OMEGA REHABILITATION SERVICES, INC.
Entity Type:Organization
Organization Name:ALPHA AND OMEGA REHABILITATION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WOODARD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:404-309-5200
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30156-0250
Mailing Address - Country:US
Mailing Address - Phone:404-309-5200
Mailing Address - Fax:
Practice Address - Street 1:2869 AMESBURY PL NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-7382
Practice Address - Country:US
Practice Address - Phone:404-309-5200
Practice Address - Fax:404-591-8002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT007989251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health