Provider Demographics
NPI: | 1942422506 |
---|---|
Name: | ALPHA CENTER |
Entity type: | Organization |
Organization Name: | ALPHA CENTER |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | LICENSED PROFESSIONAL COUNSELOR |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | ROSEMARY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SNODGRASS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LPC |
Authorized Official - Phone: | 256-765-7111 |
Mailing Address - Street 1: | PO BOX 87 |
Mailing Address - Street 2: | |
Mailing Address - City: | FLORENCE |
Mailing Address - State: | AL |
Mailing Address - Zip Code: | 35631-0087 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 256-765-7111 |
Mailing Address - Fax: | 256-765-7117 |
Practice Address - Street 1: | 3625 HELTON DRIVE |
Practice Address - Street 2: | |
Practice Address - City: | FLORENCE |
Practice Address - State: | AL |
Practice Address - Zip Code: | 35630 |
Practice Address - Country: | US |
Practice Address - Phone: | 256-765-7111 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-05-03 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
AL | 1627 | 101YP2500X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Single Specialty |