Organization
ALPHA OMEGA LIFE CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH EDWARD FARROW (EXECUTIVE DIRECTOR)
(907) 895-4104
Entity
Organization
Contact information
Practice address
2415 RAPIDS ST., DELTA JUNCTION, AK 99737-1009
(907) 895-4104
(907) 895-4143
Mailing address
PO BOX 1009, 2415 RAPIDS ST., DELTA JUNCTION, AK 99737-1009
(907) 895-4104
(907) 895-4143
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
714589
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CM2942
—
AK
05
—
CM2943
—
AK
05
—
CM3228
—
AK
05
—
CM7341
—
AK
05
—
CMG294
—
AK
05
—
PCG942
—
AK
05
—
TX2942
—
AK
Enumeration date
01/24/2007
Last updated
08/22/2020
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