Healthcare Provider Details

I. General information

NPI: 1487148169
Provider Name (Legal Business Name): ALPHA COUNSELING AND TREATMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 06/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 26TH ST STE 100
OGDEN UT
84401-2459
US

IV. Provider business mailing address

533 26TH ST STE 100
OGDEN UT
84401-2459
US

V. Phone/Fax

Practice location:
  • Phone: 385-319-7149
  • Fax: 801-459-1200
Mailing address:
  • Phone: 385-319-7149
  • Fax: 801-459-1200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY SCOTT MOORE
Title or Position: OWNER/THERAPIST
Credential:
Phone: 385-319-7149