Healthcare Provider Details
I. General information
NPI: 1295842508
Provider Name (Legal Business Name): ALLIANCE FOR HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/23/2006
Last Update Date: 12/06/2021
Certification Date: 12/06/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
105 COURT ST 2ND FLOOR
BROOKLYN NY
11201-5645
US
IV. Provider business mailing address
17855 DALLAS PKWY STE 200
DALLAS TX
75287-6857
US
V. Phone/Fax
- Phone: 718-875-8900
- Fax: 718-246-2852
- Phone: 972-201-3819
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | 1170L001 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HEATHER
SISCEL
Title or Position: VP LEGAL
Credential:
Phone: 224-221-0465