Provider Demographics
NPI:1558811836
Name:UNIWIDE ALLIANCE,LLC
Entity Type:Organization
Organization Name:UNIWIDE ALLIANCE,LLC
Other - Org Name:AIR & SURFACE QUALIFIED MEDICAL ESCORT (ASQME)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA DESIREE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAFE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:626-782-2004
Mailing Address - Street 1:703 E ORANGE GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-4489
Mailing Address - Country:US
Mailing Address - Phone:626-782-2004
Mailing Address - Fax:
Practice Address - Street 1:703 E ORANGE GROVE BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-4489
Practice Address - Country:US
Practice Address - Phone:626-782-2004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIWIDE ALLIANCE,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
146L00000X, 146N00000X, 163WA2000X, 251E00000X, 251F00000X, 251G00000X, 251J00000X, 261QA0600X, 343800000X, 343900000X, 347C00000X, 372600000X, 376G00000X, 376K00000X
CA645131163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Multi-Specialty
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Multi-Specialty
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate VehicleGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No376G00000XNursing Service Related ProvidersNursing Home AdministratorGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty