Healthcare Provider Details

I. General information

NPI: 1801961867
Provider Name (Legal Business Name): ALPHA IN HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

459 N GILBERT RD STE C120
GILBERT AZ
85234-4756
US

IV. Provider business mailing address

459 N GILBERT RD STE C120
GILBERT AZ
85234-4756
US

V. Phone/Fax

Practice location:
  • Phone: 480-827-1001
  • Fax: 480-827-1101
Mailing address:
  • Phone: 480-827-1001
  • Fax: 480-827-1101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number07528570D
License Number StateAZ

VIII. Authorized Official

Name: MS. DAWN ELAINE FIALA
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 480-827-1001