Provider Demographics
NPI:1083945380
Name:AJA PLUS HOME HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:AJA PLUS HOME HEALTH SERVICES, INC
Other - Org Name:AJA PLUS HOME HEALTH SERVICES, INC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MILES
Authorized Official - Middle Name:R
Authorized Official - Last Name:BALLESTEROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-605-2083
Mailing Address - Street 1:4295 JURUPA ST
Mailing Address - Street 2:SUITE 213
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-1428
Mailing Address - Country:US
Mailing Address - Phone:909-605-2083
Mailing Address - Fax:909-605-2085
Practice Address - Street 1:4295 JURUPA ST
Practice Address - Street 2:SUITE 213
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-1428
Practice Address - Country:US
Practice Address - Phone:909-605-2083
Practice Address - Fax:909-605-2085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health