Provider Demographics
NPI:1417407511
Name:AJRA INDEPENDENT WEALTH BUILDERS
Entity Type:Organization
Organization Name:AJRA INDEPENDENT WEALTH BUILDERS
Other - Org Name:HELPING HANDS IWB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:PARTHENIA
Authorized Official - Last Name:WADDELL
Authorized Official - Suffix:
Authorized Official - Credentials:COMPANION CARE
Authorized Official - Phone:941-877-9029
Mailing Address - Street 1:390 112TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-3505
Mailing Address - Country:US
Mailing Address - Phone:941-877-9029
Mailing Address - Fax:
Practice Address - Street 1:3639 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8434
Practice Address - Country:US
Practice Address - Phone:941-877-9029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL233959253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL233959OtherHOMEMAKER COMPANION CARE AGENCY