Healthcare Provider Details

I. General information

NPI: 1902418809
Provider Name (Legal Business Name): HOME ALLIANCE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2020
Last Update Date: 09/10/2021
Certification Date: 08/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 SUMMIT OAK COURT UNIT C
HENRICO VA
23228
US

IV. Provider business mailing address

PO BOX 399
MECHANICSVILLE VA
23111-0399
US

V. Phone/Fax

Practice location:
  • Phone: 804-397-2067
  • Fax: 903-865-5484
Mailing address:
  • Phone:
  • Fax:

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 Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TAKARA LIGGINS
Title or Position: CEO
Credential:
Phone: 804-397-2067