Provider Demographics
NPI:1043649965
Name:ALPHA SERVICE
Entity type:Organization
Organization Name:ALPHA SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RODLIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-967-6738
Mailing Address - Street 1:3207 CHATFIELD PL
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-3206
Mailing Address - Country:US
Mailing Address - Phone:316-841-9162
Mailing Address - Fax:
Practice Address - Street 1:542 N INDIANA AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4010
Practice Address - Country:US
Practice Address - Phone:405-967-6738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-01
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services