Provider Demographics
NPI:1164605242
Name:ALLIANCE CHILDREN'S & ALLIED HEALTH, INC.
Entity Type:Organization
Organization Name:ALLIANCE CHILDREN'S & ALLIED HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANELL
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:ARRN
Authorized Official - Phone:308-761-1151
Mailing Address - Street 1:204 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:NE
Mailing Address - Zip Code:69301-3826
Mailing Address - Country:US
Mailing Address - Phone:308-761-1151
Mailing Address - Fax:308-761-1139
Practice Address - Street 1:2091 BOX BUTTE AVENUE
Practice Address - Street 2:SUITE 600
Practice Address - City:ALLIANCE
Practice Address - State:NE
Practice Address - Zip Code:69301-4457
Practice Address - Country:US
Practice Address - Phone:308-761-1151
Practice Address - Fax:308-762-6657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025582600Medicaid
NE10025582600Medicaid