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Organization
ALLEGIANCE GROUP DIVERSIFIED, INC.
Active
Organization
ALLEGIANCE GROUP DIVERSIFIED, INC.
Active
Other names
Allegiance Group At Home
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DENEEN ANNETTE PALMER (CHIEF OPERATIONS OFFICER)
(703) 615-1974
Entity
Organization
Contact information
Practice address
101 E HOLLY AVE, SUITE 4, STERLING, VA 20164-5402
(703) 615-1974
(703) 738-7009
Mailing address
101 E HOLLY AVE, SUITE 4, STERLING, VA 20164-5402
(703) 615-1974
(703) 738-7009
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
B911896
VA
332B00000X
Durable Medical Equipment & Medical Supplies
B911899
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B911884
BUSINESS PROFESSIONAL AND OCCUPATIONAL LICENSE
VA
01
—
B911896
BUSINESS PROFESSIONAL AND OCCUPATIONAL LICENSE
VA
01
—
B911899
BUSINESS PROFESSIONAL AND OCCUPATIONAL LICENSE
VA
Enumeration date
06/02/2009
Last updated
06/02/2009
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