Provider Demographics
NPI:1861190589
Name:ALLIANCE CARE SERVICES LLC
Entity type:Organization
Organization Name:ALLIANCE CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AIDOO
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:614-747-4923
Mailing Address - Street 1:6908 IDLELEA DR
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-8247
Mailing Address - Country:US
Mailing Address - Phone:614-376-9241
Mailing Address - Fax:
Practice Address - Street 1:6908 IDLELEA DR
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-8247
Practice Address - Country:US
Practice Address - Phone:614-376-9241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2567968OtherDODD