Provider Demographics
NPI:1679153472
Name:ALPHA LATREIA HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:ALPHA LATREIA HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FERDINAND
Authorized Official - Middle Name:
Authorized Official - Last Name:GORGONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-975-0550
Mailing Address - Street 1:3050 FITE CIRCLE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827
Mailing Address - Country:US
Mailing Address - Phone:916-975-0550
Mailing Address - Fax:916-299-6427
Practice Address - Street 1:3050 FITE CIRCLE
Practice Address - Street 2:SUITE 210
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827
Practice Address - Country:US
Practice Address - Phone:916-975-0550
Practice Address - Fax:916-299-6427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based