Provider Demographics
NPI:1366544231
Name:ALPHA REHABILITATION, P.C.
Entity type:Organization
Organization Name:ALPHA REHABILITATION, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:R
Authorized Official - Last Name:THOENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-233-5060
Mailing Address - Street 1:920 E 56TH ST BLDG A
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-8628
Mailing Address - Country:US
Mailing Address - Phone:308-233-5060
Mailing Address - Fax:308-233-5062
Practice Address - Street 1:920 E 56TH ST BLDG A
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-8628
Practice Address - Country:US
Practice Address - Phone:308-233-5060
Practice Address - Fax:308-233-5062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE099618Medicare ID - Type UnspecifiedGROUP NUMBER