Provider Demographics
NPI:1215543897
Name:ALLEGIANT IN HOME CARE LLC
Entity Type:Organization
Organization Name:ALLEGIANT IN HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:V
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-304-1258
Mailing Address - Street 1:2180 SATELLITE BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-4927
Mailing Address - Country:US
Mailing Address - Phone:470-893-8920
Mailing Address - Fax:470-893-8930
Practice Address - Street 1:2180 SATELLITE BLVD STE 400
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-4927
Practice Address - Country:US
Practice Address - Phone:470-893-8920
Practice Address - Fax:470-893-8930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-19
Last Update Date:2020-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care