Healthcare Provider Details

I. General information

NPI: 1841317864
Provider Name (Legal Business Name): ALPHA OMEGA HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 12/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

946 W ANDREWS AVE STE U
HENDERSON NC
27536-2500
US

IV. Provider business mailing address

5950 SIX FORKS RD
RALEIGH NC
27609-3895
US

V. Phone/Fax

Practice location:
  • Phone: 252-436-0483
  • Fax:
Mailing address:
  • Phone: 919-844-1008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JOHN K HORNE
Title or Position: CEO
Credential:
Phone: 919-844-1008