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General NPI Number Information
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NPI Number | 1114198116
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Entity Type | Organization
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Legal Business Name | ALLIANCE IN-HOME CARE SERVICES LLC
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 4006 ASHFORD CIR
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City | HOLLISTER
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State | CA
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Zip | 95023-8965
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Country | US
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Telephone | 831-245-5187
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Fax |
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Provider Business Mailing Address
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Address Line | 4006 ASHFORD CIR
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City | HOLLISTER
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State | CA
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Zip | 95023-8965
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Country | US
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Telephone | 831-245-5187
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR/OWNER
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Name | MS. MAE CHACON PARK
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Credential | CERTIFIED ADM/BSBA
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Telephone | 831-245-5187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 5518
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License Number State | CA
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