=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609173277
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALLIANCE ACCESS SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/17/2011
-----------------------------------------------------
Last Update Date | 02/17/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 33300 WARREN RD SUITE 12
-----------------------------------------------------
City | WESTLAND
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48185-9627
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-266-2266
-----------------------------------------------------
Fax | 734-266-2255
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 33300 WARREN RD SUITE 12
-----------------------------------------------------
City | WESTLAND
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48185-9627
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-266-2266
-----------------------------------------------------
Fax | 734-266-2255
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER
-----------------------------------------------------
Name | MR. JONATHAN HARMON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 734-266-2266
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number | D9226F
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | D9226F
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------