Provider Demographics
NPI:1811214513
Name:ALLIANCE HOME HEALTH, LLC
Entity Type:Organization
Organization Name:ALLIANCE HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:T
Authorized Official - Last Name:SAMANIEGO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:262-652-2100
Mailing Address - Street 1:723 58TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53140-4160
Mailing Address - Country:US
Mailing Address - Phone:262-652-2100
Mailing Address - Fax:
Practice Address - Street 1:723 58TH ST STE 200
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-4160
Practice Address - Country:US
Practice Address - Phone:262-652-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health