=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659746261
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALLIANCE HUMAN SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/08/2015
-----------------------------------------------------
Last Update Date | 12/08/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14 BREAKNECK HILL RD UNIT 204
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02865-3908
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-475-3884
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 134 RUMFORD AVE SUITE 306
-----------------------------------------------------
City | AUBURNDALE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02466-1374
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | TREASURER
-----------------------------------------------------
Name | MR. FRANCIS J GRADY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 617-332-3366
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253J00000X
-----------------------------------------------------
Taxonomy Name | Foster Care Agency
-----------------------------------------------------
License Number | 68968
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------