Provider Demographics
NPI:1275264509
Name:ALLEGIANCE HEALTH SERVICE, INC
Entity Type:Organization
Organization Name:ALLEGIANCE HEALTH SERVICE, INC
Other - Org Name:ALLEGIANCE PERSONAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:EUGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDEVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-254-2560
Mailing Address - Street 1:1104 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:BASSETT
Mailing Address - State:VA
Mailing Address - Zip Code:24055-4848
Mailing Address - Country:US
Mailing Address - Phone:336-254-2560
Mailing Address - Fax:
Practice Address - Street 1:1104 SUNSET DR
Practice Address - Street 2:
Practice Address - City:BASSETT
Practice Address - State:VA
Practice Address - Zip Code:24055-4848
Practice Address - Country:US
Practice Address - Phone:336-254-2560
Practice Address - Fax:956-664-9957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-17
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care