Provider Demographics
NPI: | 1578380325 |
---|---|
Name: | ALPHA HEALTHCARE, INC. |
Entity type: | Organization |
Organization Name: | ALPHA HEALTHCARE, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | VP CORP. SEC. / BUSINESS DEV. |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | BENJAMIN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | LEONCIO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 510-396-0249 |
Mailing Address - Street 1: | 1316 COFFEE RD. |
Mailing Address - Street 2: | BLDG. B2 |
Mailing Address - City: | MODESTO |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 95355 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 510-396-0249 |
Mailing Address - Fax: | 888-300-7029 |
Practice Address - Street 1: | 4260 SISK RD STE F |
Practice Address - Street 2: | |
Practice Address - City: | MODESTO |
Practice Address - State: | CA |
Practice Address - Zip Code: | 95356-8732 |
Practice Address - Country: | US |
Practice Address - Phone: | 510-396-0249 |
Practice Address - Fax: | 888-300-7029 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-09-23 |
Last Update Date: | 2024-09-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 163WH0200X | Nursing Service Providers | Registered Nurse | Home Health | Group - Multi-Specialty |
No | 163WA2000X | Nursing Service Providers | Registered Nurse | Administrator | Group - Multi-Specialty |
No | 163WC0400X | Nursing Service Providers | Registered Nurse | Case Management | Group - Multi-Specialty |
No | 163WW0000X | Nursing Service Providers | Registered Nurse | Wound Care | Group - Multi-Specialty |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
No | 374U00000X | Nursing Service Related Providers | Home Health Aide | Group - Multi-Specialty | |
No | 405300000X | Other Service Providers | Prevention Professional | Group - Multi-Specialty |