Provider Demographics
NPI:1407032964
Name:ALPHA CARE GROUP, LLC
Entity type:Organization
Organization Name:ALPHA CARE GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUVINS
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:720-407-2909
Mailing Address - Street 1:6630 E HAMPDEN AVE STE C
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-3004
Mailing Address - Country:US
Mailing Address - Phone:720-407-2909
Mailing Address - Fax:
Practice Address - Street 1:6630 E HAMPDEN AVE STE C
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-3004
Practice Address - Country:US
Practice Address - Phone:720-407-2909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47103531251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health