MEDICARE: SALLY AL ALWANI

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1194663906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALLY AL ALWANI

Provider Business Mailing Address
First Line	:	14231 IVANHOE DR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48312-2348
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14231 IVANHOE DR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48312-2348
Country	:	US
Telephone Number	:	360-910-6450
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “ SALLY AL ALWANI ” Practice Location

Language	Start Address	Practice Location

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