Provider Demographics
NPI:1942936158
Name:ALPHA CREEK HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:ALPHA CREEK HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITEHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-425-9398
Mailing Address - Street 1:3942 RUE DE RENARD
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-2339
Mailing Address - Country:US
Mailing Address - Phone:314-425-9398
Mailing Address - Fax:
Practice Address - Street 1:3942 RUE DE RENARD
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63034-2339
Practice Address - Country:US
Practice Address - Phone:314-425-9398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health