Organization
ALLEGIANT ASSISTANT HOMECARE INC
Active
Organization
ALLEGIANT ASSISTANT HOMECARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAKIA LYNELL SMITH (CHIEF EXECUTIVE OFFICER)
(352) 512-2813
Entity
Organization
Contact information
Practice address
121 DOGWOOD DRIVE LOOP, OCALA, FL 34472-5667
(352) 512-2813
Mailing address
121 DOGWOOD DRIVE LOOP, OCALA, FL 34472-5667
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12345
MEDICAID PROVIDER
FL
Enumeration date
02/26/2020
Last updated
09/30/2021
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