MEDICARE: ALLIANCE HOME HEALTH 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1760190433
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	2140 E PARADISE LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-3446
Country	:	US
Telephone Number	:	480-404-3306
Fax Number	:	620-514-1945

Provider Business Practice Location Address
First Line	:	2140 E PARADISE LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-3446
Country	:	US
Telephone Number	:	480-404-3306
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	ROSELYN MANALO MCCORMACK
Credential	:
Telephone Number	:	480-404-3306

Provider Enumeration Date	:	11/10/2022
Last Update Date	:	11/10/2022

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