Provider Demographics
NPI:1316132665
Name:ALPHA AND OMEGA HOME CARE SERVICES OF MONROE,INC
Entity type:Organization
Organization Name:ALPHA AND OMEGA HOME CARE SERVICES OF MONROE,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-323-5447
Mailing Address - Street 1:205 EVERS ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71202-6908
Mailing Address - Country:US
Mailing Address - Phone:318-325-3051
Mailing Address - Fax:318-361-5099
Practice Address - Street 1:205 EVERS ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-6908
Practice Address - Country:US
Practice Address - Phone:318-325-3051
Practice Address - Fax:318-361-5099
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALPHA AND OMEGA HOME CARE SERVICE OF MONROE,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-10
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities