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General NPI Number Information
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NPI Number | 1326591793
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Entity Type | Organization
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Legal Business Name | ALPHACARE SUPPORT
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Dates
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Enumeration Date | 08/02/2016
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Last Update Date | 12/08/2017
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Provider Practice Location Address
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Address Line | 7809 AIRLINE DR. STE. 210
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City | METAIRIE
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State | LA
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Zip | 70003
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Country | US
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Telephone | 504-731-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 803 BAYOU PINES WEST STE. D
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City | LAKE CHARLES
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State | LA
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Zip | 70601
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. VANDELL COBB
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Credential |
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Telephone | 504-310-5952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 2205783292
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2205783292
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 2205783292
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License Number State | LA
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