Healthcare Provider Details

I. General information

NPI: 1982596029
Provider Name (Legal Business Name): ALPHA HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 07/15/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2722 HIGHWAY 694 SERVICE DRIVE STE 250
NEW BRIGHTON MN
55112
US

IV. Provider business mailing address

2722 HIGHWAY 694 SERVICE DRIVE STE 250
NEW BRIGHTON MN
55112
US

V. Phone/Fax

Practice location:
  • Phone: 763-229-5470
  • Fax:
Mailing address:
  • Phone: 763-229-5470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: HIKA NONO
Title or Position: OWNER
Credential:
Phone: 763-438-6478