Provider Demographics
NPI:1053546911
Name:ALLIANCE HEALTH CARE SERVICES, INC.
Entity type:Organization
Organization Name:ALLIANCE HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:BS W, NHA
Authorized Official - Phone:706-571-3299
Mailing Address - Street 1:4519 WOODRUFF RD
Mailing Address - Street 2:UNIT 4, BOX 1
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-6011
Mailing Address - Country:US
Mailing Address - Phone:706-571-3299
Mailing Address - Fax:706-324-0765
Practice Address - Street 1:2 GLENCASTLE CT
Practice Address - Street 2:
Practice Address - City:CORDELE
Practice Address - State:GA
Practice Address - Zip Code:31015-5370
Practice Address - Country:US
Practice Address - Phone:706-571-3299
Practice Address - Fax:706-571-3299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA251J00000XOtherPRIVATE AGENCY