Provider Demographics
NPI:1861662819
Name:ALPHA HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:ALPHA HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-225-1080
Mailing Address - Street 1:257 SOUTH OREM BLVD
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-3009
Mailing Address - Country:US
Mailing Address - Phone:801-225-1080
Mailing Address - Fax:801-225-1069
Practice Address - Street 1:257 SOUTH OREM BLVD
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-3009
Practice Address - Country:US
Practice Address - Phone:801-225-1080
Practice Address - Fax:801-225-1069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
UT2011-HHA-85759251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT467251Medicare UPIN