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General NPI Number Information
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NPI Number | 1780577841
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Entity Type | Organization
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Legal Business Name | ALPHA LED LIVING SERVICES
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 140 MUNICIPAL DR
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City | JACKSONVILLE
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State | AR
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Zip | 72076-4274
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Country | US
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Telephone | 501-902-8715
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Fax | 501-232-8549
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Provider Business Mailing Address
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Address Line | 7605 GERONIMO CIR
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-4317
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Country | US
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Telephone | 501-902-8715
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CECILIA BAKER
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Credential |
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Telephone | 501-902-8715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management 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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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