Provider Demographics
NPI:1598936817
Name:ALLIANCE IN-HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:ALLIANCE IN-HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ARCHIBALD
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:RCFE CERTIFIED ADMIN
Authorized Official - Phone:831-245-5188
Mailing Address - Street 1:4006 ASHFORD CIR
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-8965
Mailing Address - Country:US
Mailing Address - Phone:831-245-5188
Mailing Address - Fax:831-636-2903
Practice Address - Street 1:4006 ASHFORD CIR
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-8965
Practice Address - Country:US
Practice Address - Phone:831-245-5188
Practice Address - Fax:831-636-2903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health