Healthcare Provider Details

I. General information

NPI: 1730627720
Provider Name (Legal Business Name): ALLIANCE HC HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 07/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 O'BRIEN LANE
ANDOVER NJ
07821
US

IV. Provider business mailing address

1 O'BRIEN LANE
ANDOVER NJ
07821
US

V. Phone/Fax

Practice location:
  • Phone: 908-278-0987
  • Fax:
Mailing address:
  • Phone: 908-278-0987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number061902
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier061902
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerLICENSE

VIII. Authorized Official

Name: MR. CHAIM SCHEINBAUM
Title or Position: MEMBER
Credential:
Phone: 908-278-0987