Healthcare Provider Details

I. General information

NPI: 1821535956
Provider Name (Legal Business Name): ALLEGIANT HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 W WENGER RD STE C2&C3
ENGLEWOOD OH
45322-2760
US

IV. Provider business mailing address

130 W. WENGER RD SUITE 2C, 3C
ENGLEWOOD OH
45322
US

V. Phone/Fax

Practice location:
  • Phone: 937-832-0080
  • Fax: 937-832-0082
Mailing address:
  • Phone: 937-832-0080
  • Fax: 937-832-0082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number3977162
License Number StateOH

VIII. Authorized Official

Name: MRS. SYLVIA M GRUBBS
Title or Position: CLINICAL DIRECTOR
Credential: RN
Phone: 937-832-0080