| Alpha Community Support Service Llc | |
|
114 S Hancock St Rockingham NC 28379-3630 | |
| (910) 410-0459 | |
| (910) 410-0653 |
| Full Name | Alpha Community Support Service Llc |
|---|---|
| Speciality | Psychologist - Prescribing (medical) |
| Location | 114 S Hancock St, Rockingham, North Carolina |
| Authorized Official Name and Position | Michelle Yvette Ellerbe (OWNER) |
| Authorized Official Contact | 9104100459 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alpha Community Support Service Llc 114 S Hancock St Rockingham NC 28379-3630 Ph: (910) 410-0459 | Alpha Community Support Service Llc 114 S Hancock St Rockingham NC 28379-3630 Ph: (910) 410-0459 |
| NPI Number | 1518282201 |
|---|---|
| Provider Enumeration Date | 04/06/2010 |
| Last Update Date | 04/06/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518282201 | NPI | - | NPPES |
| 6006930 | Medicaid | NC | |
| 8302367 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | 33577 (North Carolina) | Primary |
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