Provider Demographics
NPI:1205044765
Name:ELDER AIDE SERVICES
Entity Type:Organization
Organization Name:ELDER AIDE SERVICES
Other - Org Name:RIGHT AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-344-0586
Mailing Address - Street 1:PO BOX 20112
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25362-1112
Mailing Address - Country:US
Mailing Address - Phone:304-344-0586
Mailing Address - Fax:304-344-0587
Practice Address - Street 1:1599 2ND AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25387-2514
Practice Address - Country:US
Practice Address - Phone:304-344-0586
Practice Address - Fax:304-344-0587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810002291Medicaid