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General NPI Number Information
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NPI Number | 1649757030
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Entity Type | Organization
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Legal Business Name | ALLEGIANCE PREMIER HOME HEALTHCARE PROVIDERS
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Dates
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Enumeration Date | 07/27/2018
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Last Update Date | 07/27/2018
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Provider Practice Location Address
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Address Line | 639 VISTA ESTE NE
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City | RIO RANCHO
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State | NM
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Zip | 87124-4783
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Country | US
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Telephone | 505-870-3271
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Fax | 877-349-7961
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Provider Business Mailing Address
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Address Line | PO BOX 44187
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City | RIO RANCHO
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State | NM
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Zip | 87174-4187
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Country | US
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Telephone | 505-870-3271
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Fax | 877-349-7961
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Authorized Official
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Title or Position | RN-OWNER
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Name | MRS. AMBER DAWN GURULE
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Credential | RN
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Telephone | 505-870-3271
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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 | 3409
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License Number State | NM
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