Provider Demographics
NPI:1548915887
Name:ALPHA RECOVERY CENTER INC
Entity type:Organization
Organization Name:ALPHA RECOVERY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAG
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:661-350-6555
Mailing Address - Street 1:7316 W AVENUE D8
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-8815
Mailing Address - Country:US
Mailing Address - Phone:661-350-6555
Mailing Address - Fax:
Practice Address - Street 1:7316 W AVENUE D8
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-8815
Practice Address - Country:US
Practice Address - Phone:661-350-6555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-15
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty