Provider Demographics
NPI:1275065112
Name:ALLIANCE HOME CARE SERVICES, LLC.
Entity Type:Organization
Organization Name:ALLIANCE HOME CARE SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DONTAVIUS
Authorized Official - Middle Name:MONQUEZ
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-779-4726
Mailing Address - Street 1:11750 CANAL ST UNIT 3-506
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7817
Mailing Address - Country:US
Mailing Address - Phone:866-616-0715
Mailing Address - Fax:866-864-9352
Practice Address - Street 1:11750 CANAL ST UNIT 3-506
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-7817
Practice Address - Country:US
Practice Address - Phone:866-616-0715
Practice Address - Fax:866-864-9352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL234700251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health