Provider Demographics
NPI:1417076761
Name:ALLIED ALTERNATIVES HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:ALLIED ALTERNATIVES HEALTHCARE SERVICES
Other - Org Name:ALLIED ALTERNATIVES THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADENYKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ISRAEL-BOLARINWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-543-8822
Mailing Address - Street 1:13 C ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4152
Mailing Address - Country:US
Mailing Address - Phone:301-543-8822
Mailing Address - Fax:310-543-8823
Practice Address - Street 1:13 C ST
Practice Address - Street 2:SUITE B
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4152
Practice Address - Country:US
Practice Address - Phone:301-543-8822
Practice Address - Fax:301-543-8823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2332251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD398100200Medicaid
MD409033100Medicaid