Provider Demographics
NPI:1689072225
Name:MAKE A MOVE ASSOCIATION
Entity Type:Organization
Organization Name:MAKE A MOVE ASSOCIATION
Other - Org Name:ALLIANCE HOME HEALTH CARE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PURIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:ACCOUNTANT
Authorized Official - Phone:918-955-6908
Mailing Address - Street 1:2604 W KENOSHA ST
Mailing Address - Street 2:SUITE 214
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-8753
Mailing Address - Country:US
Mailing Address - Phone:918-955-6908
Mailing Address - Fax:
Practice Address - Street 1:4121 W KENT ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-8753
Practice Address - Country:US
Practice Address - Phone:855-925-6683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-14
Last Update Date:2017-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251J00000X, 251T00000X, 251V00000X, 251X00000X, 253Z00000X
OK37P025220617251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No251V00000XAgenciesVoluntary or Charitable
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care