Provider Demographics
NPI:1689450371
Name:ALPAS WELLNESS LA PLATA LLC
Entity Type:Organization
Organization Name:ALPAS WELLNESS LA PLATA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEECROFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-649-4598
Mailing Address - Street 1:1014 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-4228
Mailing Address - Country:US
Mailing Address - Phone:240-342-3240
Mailing Address - Fax:
Practice Address - Street 1:1014 WASHINGTON AVE
Practice Address - Street 2:FIRST, SECOND, THIRD FLOORS
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-4228
Practice Address - Country:US
Practice Address - Phone:240-342-3240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-07
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder