Provider Demographics
NPI:1265115356
Name:ALPHA CARE LLC
Entity type:Organization
Organization Name:ALPHA CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRISCA
Authorized Official - Middle Name:EHINON
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-520-2980
Mailing Address - Street 1:209 WHITETAIL WAY
Mailing Address - Street 2:
Mailing Address - City:CADDO MILLS
Mailing Address - State:TX
Mailing Address - Zip Code:75135-6559
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:209 WHITETAIL WAY
Practice Address - Street 2:
Practice Address - City:CADDO MILLS
Practice Address - State:TX
Practice Address - Zip Code:75135-6559
Practice Address - Country:US
Practice Address - Phone:469-520-2980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant