Provider Demographics
NPI:1932653706
Name:ALPHA EDGE, LLC.
Entity Type:Organization
Organization Name:ALPHA EDGE, LLC.
Other - Org Name:ALPHA EDGE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.O.O
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:CHUKWUNENYE
Authorized Official - Last Name:ONYEKA-BEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-294-0648
Mailing Address - Street 1:811 44TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-3637
Mailing Address - Country:US
Mailing Address - Phone:202-294-0648
Mailing Address - Fax:202-747-5568
Practice Address - Street 1:811 44TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-3637
Practice Address - Country:US
Practice Address - Phone:202-294-0648
Practice Address - Fax:202-747-5568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-10
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service