Provider Demographics
NPI:1275625386
Name:ALLEGIANCE HOME CARE OF THE CAROLINAS
Entity Type:Organization
Organization Name:ALLEGIANCE HOME CARE OF THE CAROLINAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-327-9558
Mailing Address - Street 1:1363 ALDEN CT
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-9573
Mailing Address - Country:US
Mailing Address - Phone:803-327-9558
Mailing Address - Fax:803-327-9570
Practice Address - Street 1:518 NORTH AVE
Practice Address - Street 2:STE. B
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3384
Practice Address - Country:US
Practice Address - Phone:803-327-9558
Practice Address - Fax:803-327-9570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC00722251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX0779Medicaid