Provider Demographics
NPI:1578740833
Name:ALPHA OMEGA HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:ALPHA OMEGA HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:M
Authorized Official - Last Name:STOTTS
Authorized Official - Suffix:III
Authorized Official - Credentials:RN
Authorized Official - Phone:936-447-2900
Mailing Address - Street 1:10461 COMMERCE ROW STE 102
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-3251
Mailing Address - Country:US
Mailing Address - Phone:936-447-2900
Mailing Address - Fax:936-447-2999
Practice Address - Street 1:10461 COMMERCE ROW STE 102
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-3251
Practice Address - Country:US
Practice Address - Phone:936-447-2900
Practice Address - Fax:936-447-2999
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALPHA OMEGA HOME HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008846251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679014Medicare Oscar/Certification