Provider Demographics
NPI:1821283300
Name:ALPHA HOMECARE & THERAPY AGENCY LLC
Entity Type:Organization
Organization Name:ALPHA HOMECARE & THERAPY AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:CHAN
Authorized Official - Last Name:CASINGAL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:321-254-1070
Mailing Address - Street 1:3040 N WICKHAM RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-2369
Mailing Address - Country:US
Mailing Address - Phone:321-254-1070
Mailing Address - Fax:321-254-1037
Practice Address - Street 1:3040 N WICKHAM RD
Practice Address - Street 2:SUITE 7
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-2369
Practice Address - Country:US
Practice Address - Phone:321-254-1070
Practice Address - Fax:321-254-1037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299993409OtherAHCA