Provider Demographics
NPI:1932660511
Name:ALFA
Entity Type:Organization
Organization Name:ALFA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHIER
Authorized Official - Middle Name:
Authorized Official - Last Name:RESPES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-449-3190
Mailing Address - Street 1:10 LAKESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3611
Mailing Address - Country:US
Mailing Address - Phone:856-428-1100
Mailing Address - Fax:
Practice Address - Street 1:119 E CLEARVIEW AVE
Practice Address - Street 2:
Practice Address - City:PINE HILL
Practice Address - State:NJ
Practice Address - Zip Code:08021-7318
Practice Address - Country:US
Practice Address - Phone:856-238-9294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-27
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities