Provider Demographics
NPI:1043293814
Name:ALLIANCE HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:ALLIANCE HOME HEALTH SERVICES LLC
Other - Org Name:PURPOSECARE OF INDIANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-581-1100
Mailing Address - Street 1:5455 HARRISON PARK LN STE A
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46216-2245
Mailing Address - Country:US
Mailing Address - Phone:317-581-1100
Mailing Address - Fax:317-816-3131
Practice Address - Street 1:5455 HARRISON PARK LN STE A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46216-2245
Practice Address - Country:US
Practice Address - Phone:317-581-1100
Practice Address - Fax:317-816-3131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-25
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN006271251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200176190AMedicaid