Provider Demographics
NPI:1821366675
Name:ALPHA-CARE HEALTH PROFESSIONALS, LLC
Entity Type:Organization
Organization Name:ALPHA-CARE HEALTH PROFESSIONALS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:LINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-398-4100
Mailing Address - Street 1:54 W COUNTRYSIDE PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-1959
Mailing Address - Country:US
Mailing Address - Phone:630-553-9662
Mailing Address - Fax:
Practice Address - Street 1:54 W COUNTRYSIDE PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-1959
Practice Address - Country:US
Practice Address - Phone:630-553-9662
Practice Address - Fax:630-553-9692
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALPHA-CARE HEALTH PROFESSIONALS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-08
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL4000212251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health