Healthcare Provider Details

I. General information

NPI: 1093647794
Provider Name (Legal Business Name): ALIANZA COMMUNITY SUPPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1304 NEW YORK AVE
UNION CITY NJ
07087-4268
US

IV. Provider business mailing address

44 LUHMAN TER
SECAUCUS NJ
07094-4206
US

V. Phone/Fax

Practice location:
  • Phone: 201-424-1517
  • Fax:
Mailing address:
  • Phone: 201-424-1517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JORGE L REYES
Title or Position: CEO/OWNER
Credential:
Phone: 646-610-0950