Provider Demographics
NPI:1497042006
Name:ELDER AIDE HOMEMAKER SERVICES, LLC
Entity Type:Organization
Organization Name:ELDER AIDE HOMEMAKER SERVICES, LLC
Other - Org Name:ELDER AIDE HOMEMAKER SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:662-721-0837
Mailing Address - Street 1:103 S COURT ST
Mailing Address - Street 2:SUITE 128
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-2651
Mailing Address - Country:US
Mailing Address - Phone:662-721-0837
Mailing Address - Fax:
Practice Address - Street 1:103 S COURT ST
Practice Address - Street 2:SUITE 128
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-2651
Practice Address - Country:US
Practice Address - Phone:662-721-0837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-03
Last Update Date:2011-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care