Provider Demographics
NPI:1578089298
Name:ALFA
Entity Type:Organization
Organization Name:ALFA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHIER
Authorized Official - Middle Name:
Authorized Official - Last Name:RESPES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-428-1100
Mailing Address - Street 1:10 LAKESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3611
Mailing Address - Country:US
Mailing Address - Phone:856-428-1100
Mailing Address - Fax:
Practice Address - Street 1:10 LAKESIDE AVE
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-3611
Practice Address - Country:US
Practice Address - Phone:856-428-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-15
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X, 261QD1600X
NJ320600000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities