Provider Demographics
NPI:1164954467
Name:ALLEGIANCE HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:ALLEGIANCE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUMAYAH
Authorized Official - Middle Name:SALAHUDDIN
Authorized Official - Last Name:ABDULLAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-713-0311
Mailing Address - Street 1:3328 N LAKEHARBOR LN # H201
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-6256
Mailing Address - Country:US
Mailing Address - Phone:208-713-0311
Mailing Address - Fax:
Practice Address - Street 1:3328 N LAKEHARBOR LN # H201
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-6256
Practice Address - Country:US
Practice Address - Phone:208-713-0311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health