Healthcare Provider Details

I. General information

NPI: 1831365220
Provider Name (Legal Business Name): ALLIANCE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12711 RIVULET CIR
ANCHORAGE AK
99516-7317
US

IV. Provider business mailing address

12711 RIVULET CIR
ANCHORAGE AK
99516-7317
US

V. Phone/Fax

Practice location:
  • Phone: 907-838-6959
  • Fax:
Mailing address:
  • Phone: 907-838-6959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberPENDING
License Number StateAK

VIII. Authorized Official

Name: MS. AJOKE OLOHIMA WALKER
Title or Position: ADMINISTRATOR
Credential: B.A , O.N.D, C.N.A
Phone: 907-830-6959