Provider Demographics
NPI:1073348546
Name:ALLEGIANT CARE LLC
Entity type:Organization
Organization Name:ALLEGIANT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARE COORDINATOR/ CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YASELYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:UGWUBUJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-363-9318
Mailing Address - Street 1:700 EUBANK BLVD SE APT 721
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-1972
Mailing Address - Country:US
Mailing Address - Phone:505-363-9318
Mailing Address - Fax:
Practice Address - Street 1:4113 EUBANK BLVD NE STE 100C
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3482
Practice Address - Country:US
Practice Address - Phone:505-363-9318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty