Provider Demographics
NPI:1932343480
Name:ALPHA HOME HEALTH AGENCY,LLC
Entity Type:Organization
Organization Name:ALPHA HOME HEALTH AGENCY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:OZIMBA
Authorized Official - Middle Name:ERNEST
Authorized Official - Last Name:ANYANGWE
Authorized Official - Suffix:
Authorized Official - Credentials:MLT, MBA
Authorized Official - Phone:216-298-9041
Mailing Address - Street 1:14836 PURITAS AVENUE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44135
Mailing Address - Country:US
Mailing Address - Phone:216-298-9041
Mailing Address - Fax:216-298-9042
Practice Address - Street 1:14836 PURITAS AVENUE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44135
Practice Address - Country:US
Practice Address - Phone:216-298-9041
Practice Address - Fax:216-298-9042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1897116251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0091171Medicaid