Provider Demographics
NPI:1699517029
Name:ALLEGIANCE BAY CARE LLC
Entity type:Organization
Organization Name:ALLEGIANCE BAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IGNACE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSAGARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-981-2415
Mailing Address - Street 1:10 PIN OAK DR UNIT 1003
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-1017
Mailing Address - Country:US
Mailing Address - Phone:202-981-2415
Mailing Address - Fax:
Practice Address - Street 1:10 PIN OAK DR UNIT 1003
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-1017
Practice Address - Country:US
Practice Address - Phone:202-981-2415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care