Healthcare Provider Details

I. General information

NPI: 1043293814
Provider Name (Legal Business Name): ALLIANCE HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2005
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5455 HARRISON PARK LN STE A
INDIANAPOLIS IN
46216-2245
US

IV. Provider business mailing address

5455 HARRISON PARK LN STE A
INDIANAPOLIS IN
46216-2245
US

V. Phone/Fax

Practice location:
  • Phone: 317-581-1100
  • Fax: 317-816-3131
Mailing address:
  • Phone: 317-581-1100
  • Fax: 317-816-3131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number006271
License Number StateIN

VIII. Authorized Official

Name: RICHARD KELLER
Title or Position: CEO
Credential:
Phone: 317-581-1100