Provider Demographics
NPI:1437394905
Name:1ST A ALLIANCE PERSONAL CARE, LLC
Entity Type:Organization
Organization Name:1ST A ALLIANCE PERSONAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LASHUNTA
Authorized Official - Middle Name:SHARLAN
Authorized Official - Last Name:PRINGLE
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:318-255-1090
Mailing Address - Street 1:300 S FARMERVILLE ST
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-4653
Mailing Address - Country:US
Mailing Address - Phone:318-255-1090
Mailing Address - Fax:
Practice Address - Street 1:300 S FARMERVILLE ST
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-4653
Practice Address - Country:US
Practice Address - Phone:318-255-1090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15139305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization