Provider Demographics
NPI:1669653804
Name:ALLIANCE HEALTHCARE SPECIALISTS, LLC
Entity Type:Organization
Organization Name:ALLIANCE HEALTHCARE SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS-ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-747-8362
Mailing Address - Street 1:101 S BAY ST
Mailing Address - Street 2:
Mailing Address - City:AMITE
Mailing Address - State:LA
Mailing Address - Zip Code:70422-2831
Mailing Address - Country:US
Mailing Address - Phone:985-747-8362
Mailing Address - Fax:985-747-8363
Practice Address - Street 1:101 S BAY ST
Practice Address - Street 2:
Practice Address - City:AMITE
Practice Address - State:LA
Practice Address - Zip Code:70422-2831
Practice Address - Country:US
Practice Address - Phone:985-747-8362
Practice Address - Fax:985-747-8363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12456251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1471798Medicaid
LA1475084Medicaid