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NPI Code Detail

MEDICARE: HOME HEALTH ALLIANCE, LLC

MEDICARE: HOME HEALTH ALLIANCE, 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
1163WR0400XRehabilitation Registered Nurse

General Provider Information

NPI Number : 1538481676
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOME HEALTH ALLIANCE, LLC
Provider Business Mailing Address
First Line : 380 S WASHINGTON AVE
Second Line :
City : BERGENFIELD
State : NJ
Zip : 07621-4312
Country : US
Telephone Number : 201-385-3448
Fax Number :
Provider Business Practice Location Address
First Line : 380 S WASHINGTON AVE
Second Line :
City : BERGENFIELD
State : NJ
Zip : 07621-4312
Country : US
Telephone Number : 201-385-3448
Fax Number :
Authorized Official
Title or Position : CPA
Name : MR. ENRIQUE ENRIQUEZ
Credential : CPA
Telephone Number : 201-385-3448
Provider Enumeration Date : 02/16/2010
Last Update Date : 02/16/2010

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