Provider Demographics
NPI:1902026107
Name:ALLIANCE HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:ALLIANCE HEALTH SERVICES, INC
Other - Org Name:ALLIANCE HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:J
Authorized Official - Middle Name:MITCH
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-516-1401
Mailing Address - Street 1:6400 SHELBY VIEW DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-7659
Mailing Address - Country:US
Mailing Address - Phone:901-516-1800
Mailing Address - Fax:901-380-1840
Practice Address - Street 1:201 LAKEVIEW DR
Practice Address - Street 2:SUITE B
Practice Address - City:SOMERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38068
Practice Address - Country:US
Practice Address - Phone:901-465-4891
Practice Address - Fax:901-465-4770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000233251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0447086Medicaid
TN0447086Medicaid