Provider Demographics
NPI:1003501032
Name:ALLIANCE CARE & SUPPORT SERVICES
Entity Type:Organization
Organization Name:ALLIANCE CARE & SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTWAND
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-268-3652
Mailing Address - Street 1:4268 ROCKDELL HALL ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-8078
Mailing Address - Country:US
Mailing Address - Phone:919-268-3652
Mailing Address - Fax:
Practice Address - Street 1:7633 KNIGHTDALE BLVD STE 103
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-9015
Practice Address - Country:US
Practice Address - Phone:919-268-3652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care