Provider Demographics
NPI:1831819218
Name:ALPHA CARE ONE ASSISTED LIVING LLC
Entity type:Organization
Organization Name:ALPHA CARE ONE ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:
Authorized Official - Last Name:OKWOSHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-819-3882
Mailing Address - Street 1:PO BOX 41153
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27629-1153
Mailing Address - Country:US
Mailing Address - Phone:919-819-3882
Mailing Address - Fax:
Practice Address - Street 1:2060 W FIFTH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-9160
Practice Address - Country:US
Practice Address - Phone:984-232-8887
Practice Address - Fax:984-232-8984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility