Provider Demographics
NPI:1689708836
Name:ALLEGIANCE HOSPICE GROUP, INC.
Entity Type:Organization
Organization Name:ALLEGIANCE HOSPICE GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-255-4623
Mailing Address - Street 1:67 MIDDLE ST
Mailing Address - Street 2:SUITE 503
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1868
Mailing Address - Country:US
Mailing Address - Phone:877-255-4623
Mailing Address - Fax:978-275-9663
Practice Address - Street 1:67 MIDDLE ST
Practice Address - Street 2:SUITE 503
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1868
Practice Address - Country:US
Practice Address - Phone:877-255-4623
Practice Address - Fax:978-275-9663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0608076Medicaid
MA0608076Medicaid