Healthcare Provider Details

I. General information

NPI: 1750867495
Provider Name (Legal Business Name): ALLIANCE HEALTHCARE STAFFING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2018
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 MOELING ST
LAKE CHARLES LA
70601-1757
US

IV. Provider business mailing address

1731 MOELING ST
LAKE CHARLES LA
70601-1757
US

V. Phone/Fax

Practice location:
  • Phone: 337-249-2245
  • Fax:
Mailing address:
  • Phone: 337-564-6302
  • Fax: 337-564-6308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: LASHAWNA EASTON EDWARDS
Title or Position: ADMINSITRATOR
Credential:
Phone: 337-304-8308