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General NPI Number Information
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NPI Number | 1295393791
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Entity Type | Organization
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Legal Business Name | ALPHA HEALTHCARE SERVICES AND SOLUTIONS, LLC
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Dates
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Enumeration Date | 05/30/2019
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 46179 WESTLAKE DR STE 330
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City | STERLING
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State | VA
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Zip | 20165-5874
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Country | US
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Telephone | 703-589-9964
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Fax | 571-252-7100
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Provider Business Mailing Address
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Address Line | 10622 RUNAWAY LN
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City | GREAT FALLS
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State | VA
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Zip | 22066-2420
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Country | US
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Telephone | 703-589-9964
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Fax | 571-252-7100
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MUBIN JIWANI
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Credential | RN, CCS, CDIP, CRC
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Telephone | 703-589-9964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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