Provider Demographics
NPI:1093852212
Name:ALLIANCE HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:ALLIANCE HOME HEALTH CARE, INC.
Other - Org Name:ALLIANCE HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.O.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN RY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-233-0160
Mailing Address - Street 1:1831 MINNESOTA AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-4139
Mailing Address - Country:US
Mailing Address - Phone:913-233-0160
Mailing Address - Fax:913-233-0165
Practice Address - Street 1:1831 MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-4139
Practice Address - Country:US
Practice Address - Phone:913-233-0160
Practice Address - Fax:913-233-0165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA105045251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200261920AMedicaid