Healthcare Provider Details

I. General information

NPI: 1629337134
Provider Name (Legal Business Name): ALLIANCE FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2012
Last Update Date: 05/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15064 CARROLLTON BLVD
CARROLLTON VA
23314-3582
US

IV. Provider business mailing address

15064 CARROLLTON BLVD
CARROLLTON VA
23314-3582
US

V. Phone/Fax

Practice location:
  • Phone: 757-685-8789
  • Fax:
Mailing address:
  • Phone: 757-685-8789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHAWNDA DANESSA CUFFEE
Title or Position: OWNER
Credential:
Phone: 757-685-8789