Organization
ALPHA OMEGA ADULT HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAXINE E LONG (CHIEF EXECUTIVE OFFICER)
(757) 438-2340
Entity
Organization
Contact information
Practice address
3001 BAY SHORE LN, SUFFOLK, VA 23435-3175
(757) 438-2340
(757) 390-3678
Mailing address
3001 BAY SHORE LN, SUFFOLK, VA 23435-3175
(757) 438-2340
(757) 390-3678
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/29/2019
Last updated
05/29/2019
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