Healthcare Provider Details

I. General information

NPI: 1316330111
Provider Name (Legal Business Name): ALLIANCE HEALTH GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2015
Last Update Date: 03/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 PROVIDENCE MAIN ST NW STE 404
HUNTSVILLE AL
35806-4817
US

IV. Provider business mailing address

475 PROVIDENCE MAIN ST NW STE 404
HUNTSVILLE AL
35806-4817
US

V. Phone/Fax

Practice location:
  • Phone: 256-801-3600
  • Fax: 256-801-3602
Mailing address:
  • Phone: 256-801-3600
  • Fax: 256-801-3602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. YOHAN KIM
Title or Position: PRESIDENT
Credential:
Phone: 256-801-3600