Provider Demographics
NPI:1114253523
Name:AETNA HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:AETNA HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:IFEANYI
Authorized Official - Last Name:EBUEHI -NWAEFULU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-457-1100
Mailing Address - Street 1:5803 SCENIC BAY CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-5243
Mailing Address - Country:US
Mailing Address - Phone:817-457-1100
Mailing Address - Fax:817-719-9355
Practice Address - Street 1:5803 SCENIC BAY CT
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-5243
Practice Address - Country:US
Practice Address - Phone:817-457-1100
Practice Address - Fax:817-719-9355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health