Provider Demographics
NPI:1790251627
Name:ALLIANCE HEALTHCARE STAFFING
Entity Type:Organization
Organization Name:ALLIANCE HEALTHCARE STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LASHAWNA
Authorized Official - Middle Name:EASTON
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-304-8308
Mailing Address - Street 1:1731 MOELING ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-1757
Mailing Address - Country:US
Mailing Address - Phone:337-564-6302
Mailing Address - Fax:337-564-6308
Practice Address - Street 1:1731 MOELING ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-1757
Practice Address - Country:US
Practice Address - Phone:337-304-8308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-18
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA89Medicaid