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General NPI Number Information
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NPI Number | 1083432918
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Entity Type | Organization
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Legal Business Name | ALLIANCE COMMUNITY LIVING LLC
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 101 E CLAREMORE DR
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City | LANSING
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State | MI
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Zip | 48911-5060
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Country | US
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Telephone | 248-850-6576
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Fax |
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Provider Business Mailing Address
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Address Line | 101 E CLAREMORE DR
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City | LANSING
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State | MI
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Zip | 48911-5060
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Country | US
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Telephone | 248-850-6576
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LATISHA WINN
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Credential | MS, QIDP
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Telephone | 248-850-6576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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