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General NPI Number Information
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NPI Number | 1821232802
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Entity Type | Organization
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Legal Business Name | ALPHA ONE
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Dates
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Enumeration Date | 04/22/2009
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Last Update Date | 04/22/2009
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Provider Practice Location Address
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Address Line | 127 MAIN ST
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-2647
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Country | US
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Telephone | 207-767-2189
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Fax | 207-767-7386
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Provider Business Mailing Address
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Address Line | 127 MAIN ST
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-2647
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Country | US
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Telephone | 207-767-2189
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Fax | 207-799-8346
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DENNIS FITZGIBBONS
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Credential |
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Telephone | 207-767-2189
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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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