Provider Demographics
NPI:1114594793
Name:ALLIANT HOME HEALTH WI LLC
Entity Type:Organization
Organization Name:ALLIANT HOME HEALTH WI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HERONIMUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-840-7755
Mailing Address - Street 1:13720 RARITAN DR
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-7472
Mailing Address - Country:US
Mailing Address - Phone:720-840-7755
Mailing Address - Fax:
Practice Address - Street 1:1233 N MAYFAIR RD STE 301
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3255
Practice Address - Country:US
Practice Address - Phone:720-840-7755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health