Healthcare Provider Details

I. General information

NPI: 1619995446
Provider Name (Legal Business Name): ALPHA MANAGEMENT SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 05/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CONSULTANT PL
DURHAM NC
27707-3598
US

IV. Provider business mailing address

2 CONSULTANT PL
DURHAM NC
27707-3598
US

V. Phone/Fax

Practice location:
  • Phone: 919-419-0043
  • Fax: 919-489-4372
Mailing address:
  • Phone: 919-419-0043
  • Fax: 919-489-4372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. OLANTE WATSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 919-419-0043