Provider Demographics
NPI:1518675586
Name:ALLY HOME CARE LLC
Entity type:Organization
Organization Name:ALLY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALMIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:YATSENKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-971-0665
Mailing Address - Street 1:20708 E FAIR LN
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80016-3806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3090 S JAMAICA CT STE 209
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2683
Practice Address - Country:US
Practice Address - Phone:425-971-0665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care