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General NPI Number Information
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NPI Number | 1083108484
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Entity Type | Organization
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Legal Business Name | ALPHA HOME CARE SERVICES, INC.
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 06/19/2018
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Provider Practice Location Address
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Address Line | 6225A N MILWAUKEE AVE
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City | CHICAGO
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State | IL
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Zip | 60646-3730
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Country | US
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Telephone | 773-418-2061
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Fax | 773-685-2228
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Provider Business Mailing Address
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Address Line | 6225A N MILWAUKEE AVE
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City | CHICAGO
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State | IL
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Zip | 60646-3730
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Country | US
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Telephone | 773-418-2061
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Fax | 773-685-2228
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Authorized Official
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Title or Position | AGENCY MANAGER
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Name | ELIZABETH REGACHO
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Credential |
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Telephone | 773-418-2061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 4000557
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License Number State | IL
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