Provider Demographics
NPI:1043444839
Name:AAA NURSING SERVICES, INC.
Entity Type:Organization
Organization Name:AAA NURSING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WAGIH
Authorized Official - Middle Name:
Authorized Official - Last Name:KILANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-347-7009
Mailing Address - Street 1:22148 SHERMAN WAY
Mailing Address - Street 2:SUITE #203
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1139
Mailing Address - Country:US
Mailing Address - Phone:818-347-7009
Mailing Address - Fax:818-347-7013
Practice Address - Street 1:22148 SHERMAN WAY
Practice Address - Street 2:SUITE #203
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1139
Practice Address - Country:US
Practice Address - Phone:818-347-7009
Practice Address - Fax:818-347-7013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-07
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001900251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA550001900Medicaid
CA059660Medicare Oscar/Certification