Provider Demographics
NPI:1659988780
Name:ALENA HEALTHCARE AGENCY
Entity Type:Organization
Organization Name:ALENA HEALTHCARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMININSTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BAABA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABAKA-SAMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:CSCM
Authorized Official - Phone:469-469-9600
Mailing Address - Street 1:405 STATE HIGHWAY 121 BYP STE A250
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-4183
Mailing Address - Country:US
Mailing Address - Phone:469-469-9600
Mailing Address - Fax:469-754-0463
Practice Address - Street 1:405 STATE HIGHWAY 121 BYP STE A250
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4183
Practice Address - Country:US
Practice Address - Phone:469-469-9600
Practice Address - Fax:469-754-0463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care