Provider Demographics
NPI:1578704656
Name:ALPHA BEHAVIORAL HEALTH SYSTEMS, INC
Entity Type:Organization
Organization Name:ALPHA BEHAVIORAL HEALTH SYSTEMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-964-0916
Mailing Address - Street 1:111 FISK RD
Mailing Address - Street 2:
Mailing Address - City:SEAGOVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75159-2408
Mailing Address - Country:US
Mailing Address - Phone:469-964-0916
Mailing Address - Fax:512-336-2590
Practice Address - Street 1:111 FISK RD
Practice Address - Street 2:
Practice Address - City:SEAGOVILLE
Practice Address - State:TX
Practice Address - Zip Code:75159-2408
Practice Address - Country:US
Practice Address - Phone:469-964-0916
Practice Address - Fax:512-336-2590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare