Provider Demographics
NPI:1588450209
Name:ALPHA BRIDGE PLUS, INC
Entity type:Organization
Organization Name:ALPHA BRIDGE PLUS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:OLUWATISHE
Authorized Official - Middle Name:
Authorized Official - Last Name:AYOKUNLE-EDGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-931-2229
Mailing Address - Street 1:10055 RED RUN BLVD STE 190
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4686
Mailing Address - Country:US
Mailing Address - Phone:202-931-2229
Mailing Address - Fax:
Practice Address - Street 1:10055 RED RUN BLVD STE 190
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4686
Practice Address - Country:US
Practice Address - Phone:202-931-2229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility