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General NPI Number Information
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NPI Number | 1134530207
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Entity Type | Organization
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Legal Business Name | ALPHA & OMEGA FOSTER CARE SERVICE, INC
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Dates
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Enumeration Date | 05/12/2014
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Last Update Date | 05/12/2014
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Provider Practice Location Address
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Address Line | 1503 HARDY CASH DR
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City | HAMPTON
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State | VA
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Zip | 23666-2420
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Country | US
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Telephone | 757-262-2094
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Fax | 757-262-2095
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Provider Business Mailing Address
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Address Line | 1503 HARDY CASH DR
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City | HAMPTON
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State | VA
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Zip | 23666-2420
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Country | US
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Telephone | 757-262-2094
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Fax | 757-262-2095
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Authorized Official
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Title or Position | DIRECTOR OF DEVELOPMENT
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Name | MRS. JOAN DIAN SENIOR-WILLIAMSON
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Credential | LPC,
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Telephone | 757-262-2094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 981
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License Number State | VA
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