MEDICARE: ALLIANCE CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency	2203781020	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073861100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE CARE LLC

Provider Business Mailing Address
First Line	:	9121 INTERLINE AVE STE 7A
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-1973
Country	:	US
Telephone Number	:	225-456-2023
Fax Number	:

Provider Business Practice Location Address
First Line	:	9121 INTERLINE AVE STE 7A
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-1973
Country	:	US
Telephone Number	:	225-456-2023
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	CARL KEPHART
Credential	:
Telephone Number	:	225-456-2023

Provider Enumeration Date	:	08/21/2012
Last Update Date	:	08/21/2012

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Directions to “ALLIANCE CARE LLC ” Practice Location

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