Healthcare Provider Details
I. General information
NPI: 1114702560
Provider Name (Legal Business Name): ALLIANCE HEALTH AND HOMECARE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/25/2023
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8024 GLENWOOD AVE
RALEIGH NC
27612-1912
US
IV. Provider business mailing address
5008 OXFORDSHIRE RD
WAXHAW NC
28173-7324
US
V. Phone/Fax
- Phone: 704-652-1955
- Fax: 704-983-0967
- Phone: 704-652-1955
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WH0200X |
| Taxonomy | Home Health Registered Nurse |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CARLENE
BOWDEN
Title or Position: OWNER
Credential:
Phone: 704-983-0959