Organization
ALPHA NURSING SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE GORDON R.N. CLC (DIRECTOR)
(440) 479-2254
Entity
Organization
Contact information
Practice address
5559 REDWOOD DR, WILLOUGHBY, OH 44094-3222
(216) 712-0798
Mailing address
5559 REDWOOD DR, WILLOUGHBY, OH 44094-3222
(216) 712-0798
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP820172
DL
OH
Enumeration date
08/04/2022
Last updated
08/04/2022
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