Provider Demographics
NPI:1063279511
Name:ALLEGIANCE HOME HEALTHCARE AGENCY
Entity type:Organization
Organization Name:ALLEGIANCE HOME HEALTHCARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-501-9237
Mailing Address - Street 1:816 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-1704
Mailing Address - Country:US
Mailing Address - Phone:989-482-6729
Mailing Address - Fax:989-270-3200
Practice Address - Street 1:141 HARROW LN
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-6093
Practice Address - Country:US
Practice Address - Phone:989-482-6729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care