Healthcare Provider Details

I. General information

NPI: 1205858461
Provider Name (Legal Business Name): ALPHA COMMUNITY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 ROBIN HOOD RD STE 108
NORFOLK VA
23513-2419
US

IV. Provider business mailing address

1109 GLADIOLA CRES
VIRGINIA BEACH VA
23453-2305
US

V. Phone/Fax

Practice location:
  • Phone: 757-792-5190
  • Fax: 757-689-4865
Mailing address:
  • Phone: 757-635-6573
  • Fax: 757-689-4865

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 Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number699-01-001
License Number StateVA

VIII. Authorized Official

Name: KATHRON NICHOLS
Title or Position: PROGRAM DIRECTOR
Credential: QMHP
Phone: 757-635-6573