Organization
ALPHA & OMEGA SUPPORTED LIVING AGENCY, LLC
Active
Other names
Alpha & Omega Supported Living Agency, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA VICTORIA LOPEZ BSBM (CEO)
(614) 626-8817
Entity
Organization
Contact information
Practice address
1589 BRICE RD, REYNOLDSBURG, OH 43068-2701
(614) 626-8817
(614) 694-0573
Mailing address
2236 S HAMILTON RD STE 104, COLUMBUS, OH 43232-4381
(614) 626-8817
(614) 694-0573
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0326268
—
OH
Enumeration date
02/20/2019
Last updated
04/08/2025
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