Provider Demographics
NPI:1750318135
Name:ALLIANCE CARE OF OHIO, LLC
Entity Type:Organization
Organization Name:ALLIANCE CARE OF OHIO, LLC
Other - Org Name:ALLIANCECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOUTHITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-244-3603
Mailing Address - Street 1:2500 QUANTUM LAKES DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8324
Mailing Address - Country:US
Mailing Address - Phone:561-244-0222
Mailing Address - Fax:561-244-0221
Practice Address - Street 1:2500 QUANTUM LAKES DR
Practice Address - Street 2:SUITE 108
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8324
Practice Address - Country:US
Practice Address - Phone:561-244-0222
Practice Address - Fax:561-244-0221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========OtherTAX ID #
OHAL9358521Medicare ID - Type UnspecifiedGRP PRACTICE ID #