Healthcare Provider Details

I. General information

NPI: 1063046332
Provider Name (Legal Business Name): ALLEGIANT ASSISTANT HOMECARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2020
Last Update Date: 09/30/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 DOGWOOD DRIVE LOOP
OCALA FL
34472-5667
US

IV. Provider business mailing address

121 DOGWOOD DRIVE LOOP
OCALA FL
34472-5667
US

V. Phone/Fax

Practice location:
  • Phone: 352-512-2813
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: NAKIA LYNELL SMITH
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 352-512-2813