Provider Demographics
NPI:1942751185
Name:ALLSTAR HOMECARE ALLIANCE
Entity Type:Organization
Organization Name:ALLSTAR HOMECARE ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:I
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-318-0195
Mailing Address - Street 1:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:WEST WARREN
Mailing Address - State:MA
Mailing Address - Zip Code:01092-0186
Mailing Address - Country:US
Mailing Address - Phone:774-318-0195
Mailing Address - Fax:
Practice Address - Street 1:379 CROUCH RD
Practice Address - Street 2:
Practice Address - City:W. WARREN
Practice Address - State:MA
Practice Address - Zip Code:01092
Practice Address - Country:US
Practice Address - Phone:774-318-0195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA001238937251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health