Provider Demographics
NPI:1487148169
Name:ALPHA COUNSELING AND TREATMENT, INC.
Entity type:Organization
Organization Name:ALPHA COUNSELING AND TREATMENT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:385-319-7149
Mailing Address - Street 1:533 26TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-2459
Mailing Address - Country:US
Mailing Address - Phone:385-319-7149
Mailing Address - Fax:801-459-1200
Practice Address - Street 1:533 26TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-2459
Practice Address - Country:US
Practice Address - Phone:385-319-7149
Practice Address - Fax:801-459-1200
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALPHA COUNSELING AND TREATMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty