Provider Demographics
NPI:1750469276
Name:ALPHA RECOVERY CENTER, LLC
Entity Type:Organization
Organization Name:ALPHA RECOVERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:FLOYD
Authorized Official - Last Name:OSTRANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-766-6103
Mailing Address - Street 1:1677 E 400TH RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-9101
Mailing Address - Country:US
Mailing Address - Phone:785-766-6103
Mailing Address - Fax:
Practice Address - Street 1:1031 VERMONT ST
Practice Address - Street 2:SUITE F
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2921
Practice Address - Country:US
Practice Address - Phone:785-842-2343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS433251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health