Provider Demographics
NPI:1659627776
Name:ALLIANCE COMMUNITY CONNECTIONS INC
Entity Type:Organization
Organization Name:ALLIANCE COMMUNITY CONNECTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:N
Authorized Official - Last Name:NJINE
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:781-281-1626
Mailing Address - Street 1:331 MONTVALE AVE
Mailing Address - Street 2:SUITE 650
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801
Mailing Address - Country:US
Mailing Address - Phone:781-281-1626
Mailing Address - Fax:781-281-1627
Practice Address - Street 1:331 MONTVALE AVE
Practice Address - Street 2:SUITE 650
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801
Practice Address - Country:US
Practice Address - Phone:781-281-1626
Practice Address - Fax:781-281-1627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-26
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAE038004251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health