Provider Demographics
NPI:1720850506
Name:ALPHA OMEGA HEALTH MANAGEMENT SERVICES, LLC
Entity Type:Organization
Organization Name:ALPHA OMEGA HEALTH MANAGEMENT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DELORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANNON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:409-234-8482
Mailing Address - Street 1:1413 S HIGHWAY 69 STE 11
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-7842
Mailing Address - Country:US
Mailing Address - Phone:409-234-8480
Mailing Address - Fax:409-234-8482
Practice Address - Street 1:1413 S HIGHWAY 69 STE 11
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-7842
Practice Address - Country:US
Practice Address - Phone:409-234-8480
Practice Address - Fax:409-234-8482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No251B00000XAgenciesCase Management
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health