MEDICARE: ALLIANCE MEMORIAL HEALTHCARE, 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	251E00000X	Home Health Agency	009444	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	009444	OTHER	TX	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1912079617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE MEMORIAL HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	708 MAIN ST STE 500
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-3219
Country	:	US
Telephone Number	:	713-227-9990
Fax Number	:	713-227-9960

Provider Business Practice Location Address
First Line	:	708 MAIN ST STE 500
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-3219
Country	:	US
Telephone Number	:	713-227-9990
Fax Number	:	713-227-9960

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. JAMES L PATTERSON
Credential	:
Telephone Number	:	713-227-9990

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	08/22/2020

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