Provider Demographics
NPI:1679847933
Name:ALLIANCE CARE OF ATLANTA, INC
Entity Type:Organization
Organization Name:ALLIANCE CARE OF ATLANTA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:CASTLE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:678-417-1600
Mailing Address - Street 1:3500 DULUTH PARK LN
Mailing Address - Street 2:SUITE 810
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3242
Mailing Address - Country:US
Mailing Address - Phone:678-417-1600
Mailing Address - Fax:678-417-1603
Practice Address - Street 1:3500 DULUTH PARK LN
Practice Address - Street 2:SUITE 810
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3242
Practice Address - Country:US
Practice Address - Phone:678-417-1600
Practice Address - Fax:678-417-1603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA067-R-0033251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health