Provider Demographics
NPI:1407436728
Name:ALLIANCE HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:ALLIANCE HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:A
Authorized Official - Last Name:DANKWAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-486-4074
Mailing Address - Street 1:7507 WOODSIDE LN APT 13
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-2033
Mailing Address - Country:US
Mailing Address - Phone:703-486-4074
Mailing Address - Fax:
Practice Address - Street 1:7507 WOODSIDE LN APT 13
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-2033
Practice Address - Country:US
Practice Address - Phone:703-486-4074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-11
Last Update Date:2021-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAHCO-212590OtherVIRGINIA DEPARTMENT OF HEALTH