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General NPI Number Information
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NPI Number | 1689111056
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Entity Type | Organization
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Legal Business Name | ALPHA SENIOR HOME CARE LLC
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Dates
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Enumeration Date | 01/24/2017
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Last Update Date | 01/24/2017
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Provider Practice Location Address
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Address Line | 16 GRANT AVE
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City | AMITYVILLE
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State | NY
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Zip | 11701-2305
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Country | US
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Telephone | 631-365-0671
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Fax | 631-608-3796
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Provider Business Mailing Address
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Address Line | 16 GRANT AVE
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City | AMITYVILLE
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State | NY
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Zip | 11701-2305
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Country | US
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Telephone | 631-365-0671
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Fax | 631-608-3796
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. YVONNE R STEWART
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Credential |
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Telephone | 631-507-3673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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