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General NPI Number Information
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NPI Number | 1538896063
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Entity Type | Organization
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Legal Business Name | ALPHA NURSING SERVICE
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Dates
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Enumeration Date | 08/04/2022
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 5559 REDWOOD DR
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City | WILLOUGHBY
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State | OH
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Zip | 44094-3222
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Country | US
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Telephone | 216-712-0798
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Fax |
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Provider Business Mailing Address
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Address Line | 5559 REDWOOD DR
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City | WILLOUGHBY
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State | OH
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Zip | 44094-3222
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Country | US
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Telephone | 216-712-0798
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ANNETTE GORDON
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Credential | R.N. CLC
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Telephone | 440-479-2254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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