Provider Demographics
NPI:1619681996
Name:ALPHA II OMEGA BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:ALPHA II OMEGA BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-CEO/ DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-220-6512
Mailing Address - Street 1:621 STEMMERS RUN RD STE F
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221-3386
Mailing Address - Country:US
Mailing Address - Phone:410-775-5533
Mailing Address - Fax:
Practice Address - Street 1:621 STEMMERS RUN RD STE F
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-3386
Practice Address - Country:US
Practice Address - Phone:410-775-5533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALPHA II OMEGA BEHAVIORAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-11
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder