Healthcare Provider Details

I. General information

NPI: 1376811968
Provider Name (Legal Business Name): ALPHA CARE LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2011
Last Update Date: 12/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 W 20TH ST
LORAIN OH
44052-3779
US

IV. Provider business mailing address

12590 BAUMHART RD
AMHERST OH
44001-9773
US

V. Phone/Fax

Practice location:
  • Phone: 440-244-2333
  • Fax:
Mailing address:
  • Phone: 440-225-8402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number2895247
License Number StateOH

VIII. Authorized Official

Name: MR. TODD WAYNE ROBY
Title or Position: CEO
Credential: RN
Phone: 440-225-8402