MEDICARE: ALLIANCE CASE MANAGEMENT LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1134890619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE CASE MANAGEMENT LLC.

Provider Business Mailing Address
First Line	:	10682 TWO NOTCH RD APT 5106
Second Line	:
City	:	ELGIN
State	:	SC
Zip	:	29045-0016
Country	:	US
Telephone Number	:	803-459-2408
Fax Number	:

Provider Business Practice Location Address
First Line	:	117 ALPINE CIR STE 600-E
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-6523
Country	:	US
Telephone Number	:	803-459-2408
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DESIREE SPANN
Credential	:
Telephone Number	:	803-459-2408

Provider Enumeration Date	:	09/23/2021
Last Update Date	:	09/23/2021

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