Provider Demographics
NPI:1164656880
Name:A.N.H ENTERPRISES LC - SERIES 3
Entity Type:Organization
Organization Name:A.N.H ENTERPRISES LC - SERIES 3
Other - Org Name:ALTA MODA HOME HEALTH CARE LC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDIAZIZ
Authorized Official - Middle Name:N
Authorized Official - Last Name:HAJIABDIRAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-981-6270
Mailing Address - Street 1:921 3RD ST SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-2147
Mailing Address - Country:US
Mailing Address - Phone:319-981-6270
Mailing Address - Fax:
Practice Address - Street 1:921 3RD ST SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-2147
Practice Address - Country:US
Practice Address - Phone:319-981-6270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-09
Last Update Date:2009-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care