Provider Demographics
NPI:1104604172
Name:ALLIANCE HOME CARE, LLC
Entity type:Organization
Organization Name:ALLIANCE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHILO
Authorized Official - Middle Name:
Authorized Official - Last Name:ANNIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:888-451-5273
Mailing Address - Street 1:PO BOX 447
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 POST OFFICE SQ
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-1557
Practice Address - Country:US
Practice Address - Phone:888-451-5273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care