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General NPI Number Information
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NPI Number | 1932653706
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Entity Type | Organization
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Legal Business Name | ALPHA EDGE, LLC.
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Dates
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Enumeration Date | 08/10/2016
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 811 44TH ST NE
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City | WASHINGTON
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State | DC
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Zip | 20019-3637
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Country | US
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Telephone | 202-294-0648
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Fax | 202-747-5568
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Provider Business Mailing Address
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Address Line | 811 44TH ST NE
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City | WASHINGTON
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State | DC
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Zip | 20019-3637
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Country | US
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Telephone | 202-294-0648
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Fax | 202-747-5568
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Authorized Official
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Title or Position | C.O.O
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Name | MR. VICTOR CHUKWUNENYE ONYEKA-BEN
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Credential |
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Telephone | 202-294-0648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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