Provider Demographics
NPI:1265499636
Name:THE ALLIANCE HOME OF CARLISLE, PA
Entity Type:Organization
Organization Name:THE ALLIANCE HOME OF CARLISLE, PA
Other - Org Name:CHAPEL POINTE AT CARLISLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:SPRAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:717-249-1363
Mailing Address - Street 1:770 S HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-4105
Mailing Address - Country:US
Mailing Address - Phone:717-249-1363
Mailing Address - Fax:717-249-4551
Practice Address - Street 1:770 S HANOVER ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-4105
Practice Address - Country:US
Practice Address - Phone:717-249-1363
Practice Address - Fax:717-249-4551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA010602314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00745163Medicaid
PA00745163Medicaid