Healthcare Provider Details

I. General information

NPI: 1962118349
Provider Name (Legal Business Name): ALPHA HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2023
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1908 SKYLINE DR N
BURNSVILLE MN
55337-2928
US

IV. Provider business mailing address

1908 SKYLINE DR N
BURNSVILLE MN
55337-2928
US

V. Phone/Fax

Practice location:
  • Phone: 952-212-8981
  • Fax:
Mailing address:
  • Phone: 952-212-8981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. EMILLY ONDARA
Title or Position: ASSISTED LIVING DIRECTOR
Credential:
Phone: 952-594-4862