Healthcare Provider Details

I. General information

NPI: 1295662625
Provider Name (Legal Business Name): ALLIANCE CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 COLLEGE ST APT 9
LEWISTON ME
04240-6808
US

IV. Provider business mailing address

215 OAK GROVE ST APT 1309
MINNEAPOLIS MN
55403-3355
US

V. Phone/Fax

Practice location:
  • Phone: 612-449-4880
  • Fax:
Mailing address:
  • Phone: 612-449-4880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: DINEMA B MATE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 612-448-4990