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General NPI Number Information
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NPI Number | 1174722789
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Entity Type | Organization
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Legal Business Name | ALPHA SUPPORTED LIVING SERVICES, INC
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 07/13/2007
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Provider Practice Location Address
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Address Line | 3401 RIDGELAKE DR 105
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City | METAIRIE
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State | LA
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Zip | 70002-3713
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Country | US
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Telephone | 504-834-8086
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Fax | 504-634-8098
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Provider Business Mailing Address
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Address Line | PO BOX 77710
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City | BATON ROUGE
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State | LA
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Zip | 70879-7710
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Country | US
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Telephone | 504-834-8086
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Fax | 504-834-8098
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Authorized Official
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Title or Position | COMMUNITY LIAISON
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Name | MRS. PAMELA B CARTER
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Credential |
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Telephone | 504-834-8086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 7463
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License Number State | LA
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