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General NPI Number Information
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NPI Number | 1770004962
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Entity Type | Organization
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Legal Business Name | ALPHA THERAPEUTIC SERVICES LLC
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 04/17/2019
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Provider Practice Location Address
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Address Line | 636 NORTHLAND BLVD
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City | CINCINNATI
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State | OH
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Zip | 45240-3221
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Country | US
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Telephone | 513-259-6174
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Fax |
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Provider Business Mailing Address
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Address Line | 636 NORTHLAND BLVD STE 250
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City | CINCINNATI
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State | OH
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Zip | 45240-3221
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Country | US
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Telephone | 513-295-3219
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Fax | 513-672-2722
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Authorized Official
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Title or Position | CEO
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Name | DR. LINDA JOHNSON
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Credential |
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Telephone | 513-259-6174
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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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