1487148169 NPI number — ALPHA COUNSELING AND TREATMENT, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487148169 NPI number — ALPHA COUNSELING AND TREATMENT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALPHA COUNSELING AND TREATMENT, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487148169
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/18/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
533 26TH ST STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OGDEN
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84401-2459
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
385-319-7149
Provider Business Mailing Address Fax Number:
801-459-1200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
533 26TH ST STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OGDEN
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84401-2459
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
385-319-7149
Provider Business Practice Location Address Fax Number:
801-459-1200
Provider Enumeration Date:
06/18/2018

Additional Information

Authorized Official

Authorized Official Last Name:
MOORE
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
SCOTT
Authorized Official Title or Position:
OWNER/THERAPIST
Authorized Official Telephone Number:
385-319-7149

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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