Provider Demographics
NPI:1588845689
Name:ALPHA & OMEGA HOME HEALTH AGENCY, CORP
Entity Type:Organization
Organization Name:ALPHA & OMEGA HOME HEALTH AGENCY, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARSENIO
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-643-2180
Mailing Address - Street 1:2742 SW 8TH ST STE 217
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-4637
Mailing Address - Country:US
Mailing Address - Phone:305-863-2233
Mailing Address - Fax:305-504-8813
Practice Address - Street 1:2742 SW 8TH ST
Practice Address - Street 2:SUITE 217
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4660
Practice Address - Country:US
Practice Address - Phone:305-643-2180
Practice Address - Fax:305-643-2186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109202Medicare Oscar/Certification