Healthcare Provider Details

I. General information

NPI: 1801267232
Provider Name (Legal Business Name): ALLIANCE FAMILY HEALTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2015
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S ARCH AVE
ALLIANCE OH
44601-4288
US

IV. Provider business mailing address

270 E STATE ST STE G110
ALLIANCE OH
44601-4957
US

V. Phone/Fax

Practice location:
  • Phone: 330-596-7580
  • Fax: 330-596-7585
Mailing address:
  • Phone: 330-596-7580
  • Fax: 330-596-7585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: DALE W WELLS
Title or Position: DIRECTOR
Credential:
Phone: 330-596-7066