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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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