Provider Demographics
NPI:1508353160
Name:AVEIDA HOME CARE LLC
Entity Type:Organization
Organization Name:AVEIDA HOME CARE LLC
Other - Org Name:AVEIDA HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LATIMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-400-2610
Mailing Address - Street 1:302 S 18TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-2628
Mailing Address - Country:US
Mailing Address - Phone:707-731-3646
Mailing Address - Fax:
Practice Address - Street 1:302 S 18TH STREET
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804
Practice Address - Country:US
Practice Address - Phone:707-731-3646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-19
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care