Provider Demographics
NPI:1942604202
Name:ALPHA HEALING CENTER, LLC
Entity Type:Organization
Organization Name:ALPHA HEALING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-226-7050
Mailing Address - Street 1:68 CULVER RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-2802
Mailing Address - Country:US
Mailing Address - Phone:732-313-0047
Mailing Address - Fax:201-222-7676
Practice Address - Street 1:600 PAVONIA AVE
Practice Address - Street 2:8TH FLOOR
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-2929
Practice Address - Country:US
Practice Address - Phone:732-313-0047
Practice Address - Fax:201-222-7676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder