Provider Demographics
NPI:1629595848
Name:AALPHA RESOURCES, LLC
Entity Type:Organization
Organization Name:AALPHA RESOURCES, LLC
Other - Org Name:AALPHA RESOURCES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHARONDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:504-512-3037
Mailing Address - Street 1:3925 N I 10 SERVICE RD W STE 129
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-6831
Mailing Address - Country:US
Mailing Address - Phone:504-592-6920
Mailing Address - Fax:504-605-4657
Practice Address - Street 1:3925 N I 10 SERVICE RD W STE 223
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-6858
Practice Address - Country:US
Practice Address - Phone:504-592-6920
Practice Address - Fax:504-605-4657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-28
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA=========Medicaid