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Organization

ALPHA COMMUNITY SUPPORT SERVICE LLC

Active
Parent organization
ALPHA COMMUNITY SUPPORT SERVICE LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
ALPHA COMMUNITY SUPPORT SERVICE LLC
Authorized official
MS. MICHELLE YVETTE ELLERBE MA, QP (OWNER)
(910) 410-0459
Entity
Organization

Contact information

Practice address
114 S HANCOCK ST, ROCKINGHAM, NC 28379-3630
(910) 410-0459
(910) 410-0653
Mailing address
114 S HANCOCK ST, ROCKINGHAM, NC 28379-3630
(910) 410-0459
(910) 410-0653

Taxonomy

Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
33577
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6006930
NC
05
8302367
NC
Enumeration date
04/06/2010
Last updated
04/06/2010
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