Provider Demographics
NPI:1134872690
Name:ALPHA CARE LLC
Entity type:Organization
Organization Name:ALPHA CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BWIACHINGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-298-7909
Mailing Address - Street 1:19201 BLUE STEM CT
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-5497
Mailing Address - Country:US
Mailing Address - Phone:612-298-7909
Mailing Address - Fax:
Practice Address - Street 1:19201 BLUE STEM CT
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55311-5497
Practice Address - Country:US
Practice Address - Phone:612-298-7909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty