Provider Demographics
NPI:1134530207
Name:ALPHA & OMEGA FOSTER CARE SERVICE, INC
Entity type:Organization
Organization Name:ALPHA & OMEGA FOSTER CARE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF DEVELOPMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:DIAN
Authorized Official - Last Name:SENIOR-WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,
Authorized Official - Phone:757-262-2094
Mailing Address - Street 1:1503 HARDY CASH DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2420
Mailing Address - Country:US
Mailing Address - Phone:757-262-2094
Mailing Address - Fax:757-262-2095
Practice Address - Street 1:1503 HARDY CASH DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2420
Practice Address - Country:US
Practice Address - Phone:757-262-2094
Practice Address - Fax:757-262-2095
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALPHA COUNSELLORS SERVICE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA981302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization