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General NPI Number Information
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NPI Number | 1851424998
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Entity Type | Organization
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Legal Business Name | ALPHA OMEGA CONSULTING, INC.
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 805 E JOHNS AVE
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City | DECATUR
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State | IL
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Zip | 62521-2681
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Country | US
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Telephone | 217-422-4725
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Fax |
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Provider Business Mailing Address
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Address Line | 805 E JOHNS AVE
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City | DECATUR
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State | IL
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Zip | 62521-2681
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Country | US
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Telephone | 217-422-4725
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ANGELA CORNELL
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Credential |
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Telephone | 217-422-4725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 0046987
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License Number State | IL
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