Provider Demographics
NPI:1851675748
Name:ALLIANCE CARE LLC
Entity Type:Organization
Organization Name:ALLIANCE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:KEPHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-456-2023
Mailing Address - Street 1:9121 INTERLINE AVE STE 7A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1973
Mailing Address - Country:US
Mailing Address - Phone:225-456-2023
Mailing Address - Fax:225-456-2026
Practice Address - Street 1:9121 INTERLINE AVE STE 7A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1973
Practice Address - Country:US
Practice Address - Phone:225-456-2023
Practice Address - Fax:225-456-2026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-10
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1162981Medicaid