Provider Demographics
NPI:1295393791
Name:ALPHA HEALTHCARE SERVICES AND SOLUTIONS, LLC
Entity type:Organization
Organization Name:ALPHA HEALTHCARE SERVICES AND SOLUTIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MUBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JIWANI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CCS, CDIP, CRC
Authorized Official - Phone:703-589-9964
Mailing Address - Street 1:10622 RUNAWAY LN
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-2420
Mailing Address - Country:US
Mailing Address - Phone:703-589-9964
Mailing Address - Fax:571-252-7100
Practice Address - Street 1:46179 WESTLAKE DR STE 330
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-5874
Practice Address - Country:US
Practice Address - Phone:703-589-9964
Practice Address - Fax:571-252-7100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1548488927Medicaid
VA1619412673Medicaid
TX1871007377Medicaid
VA1619732468Medicaid
VA1841554912Medicaid
VA1114459732OtherNPI
VA1174120547Medicaid