Provider Demographics
NPI:1164850707
Name:AVIANA HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:AVIANA HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALLYSIA
Authorized Official - Middle Name:SANH
Authorized Official - Last Name:THAMPITHAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-276-2428
Mailing Address - Street 1:7671 LITTLE BEND CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-2945
Mailing Address - Country:US
Mailing Address - Phone:907-602-2710
Mailing Address - Fax:
Practice Address - Street 1:7671 LITTLE BEND CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-2945
Practice Address - Country:US
Practice Address - Phone:907-602-2710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK994762251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health