MEDICARE: ALLIANCE IN-HOME CARE, 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	HCO-07426	VA

General Provider Information

NPI Number	:	1902002686
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE IN-HOME CARE, LLC

Provider Business Mailing Address
First Line	:	6201 LEESBURG PIKE STE 6
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-2201
Country	:	US
Telephone Number	:	703-825-1067
Fax Number	:

Provider Business Practice Location Address
First Line	:	6201 LEESBURG PIKE STE 6
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-2201
Country	:	US
Telephone Number	:	703-825-1067
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. PRISCILLA R. CASTILLO-HESS
Credential	:	MHS, CSA
Telephone Number	:	703-625-1067

Provider Enumeration Date	:	06/21/2007
Last Update Date	:	08/22/2020

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