Provider Demographics
NPI:1467140558
Name:AIMS SUPPORTED LIVING, LLC
Entity Type:Organization
Organization Name:AIMS SUPPORTED LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AWAL
Authorized Official - Middle Name:
Authorized Official - Last Name:INUSA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA-HCA
Authorized Official - Phone:614-505-0694
Mailing Address - Street 1:1415 E DUBLIN GRANVILLE RD STE 215
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3311
Mailing Address - Country:US
Mailing Address - Phone:614-505-0694
Mailing Address - Fax:
Practice Address - Street 1:1415 E DUBLIN GRANVILLE RD STE 215
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3311
Practice Address - Country:US
Practice Address - Phone:614-505-0694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty