Healthcare Provider Details

I. General information

NPI: 1134630767
Provider Name (Legal Business Name): ALPHA HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2017
Last Update Date: 10/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5026 SABRELINE TER
GREENACRES FL
33463-5956
US

IV. Provider business mailing address

5026 SABRELINE TER
GREENACRES FL
33463-5956
US

V. Phone/Fax

Practice location:
  • Phone: 561-767-0765
  • Fax:
Mailing address:
  • Phone: 561-767-0765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JOCELYN AUGUSTIN
Title or Position: OWNER
Credential:
Phone: 561-767-0765