Healthcare Provider Details

I. General information

NPI: 1235041716
Provider Name (Legal Business Name): ALLIANCE FAMILY HEALTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 GLAMORGAN ST
ALLIANCE OH
44601-2860
US

IV. Provider business mailing address

1401 S ARCH AVE
ALLIANCE OH
44601-4288
US

V. Phone/Fax

Practice location:
  • Phone: 330-249-7011
  • Fax:
Mailing address:
  • Phone: 330-249-7011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AMANDA NELSON
Title or Position: CHIEF OPERATIONS/COMPLIANCE OFFICER
Credential: MPH, LPN, CHPI
Phone: 330-249-7011