Provider Demographics
NPI:1871655530
Name:ALLIANCE THERAPY, LLP
Entity Type:Organization
Organization Name:ALLIANCE THERAPY, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LANDA
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:701-356-0062
Mailing Address - Street 1:1207 PRAIRIE PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-3145
Mailing Address - Country:US
Mailing Address - Phone:701-356-0062
Mailing Address - Fax:701-356-5412
Practice Address - Street 1:1207 PRAIRIE PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-3145
Practice Address - Country:US
Practice Address - Phone:701-356-0062
Practice Address - Fax:701-356-5412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND225100000X, 225X00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND51191Medicaid