Provider Demographics
NPI:1144636572
Name:A & A ABOUT HOME CARE, INC.
Entity type:Organization
Organization Name:A & A ABOUT HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:DOREEN
Authorized Official - Last Name:ROEDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-455-0857
Mailing Address - Street 1:202 E ASH ST
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83605-5203
Mailing Address - Country:US
Mailing Address - Phone:208-455-0857
Mailing Address - Fax:208-455-7918
Practice Address - Street 1:202 E ASH ST
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-5203
Practice Address - Country:US
Practice Address - Phone:208-455-0857
Practice Address - Fax:208-455-7918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-07
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDM804061900Medicaid