1700437829 NPI number — ALPHA RECOVERY HEALTHCARE SERVICES INC.

Table of content: DR. NICHOLAS LEVI JASON D.C (NPI 1336413079)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700437829 NPI number — ALPHA RECOVERY HEALTHCARE SERVICES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALPHA RECOVERY HEALTHCARE SERVICES 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:
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:
1700437829
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2014 WHISTLING DUCK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UPPER MARLBORO
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20774-7139
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-821-2195
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9701 APOLLO DR STE 293
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UPPER MARLBORO
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20774-4789
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-821-2195
Provider Business Practice Location Address Fax Number:
301-390-0463
Provider Enumeration Date:
09/20/2019

Additional Information

Authorized Official

Authorized Official Last Name:
OYENUGA
Authorized Official First Name:
AYOOLA
Authorized Official Middle Name:
JULIANA
Authorized Official Title or Position:
MENTAL HEALTH NURSE PRACTITIONER
Authorized Official Telephone Number:
240-821-2195

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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