Provider Demographics
NPI:1528415957
Name:AIC HEALTH CARE, INC.
Entity Type:Organization
Organization Name:AIC HEALTH CARE, INC.
Other - Org Name:RUUS HOME ICF/DD-H
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MACATANGAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:510-378-5167
Mailing Address - Street 1:27489 PORTSMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-4014
Mailing Address - Country:US
Mailing Address - Phone:510-293-3023
Mailing Address - Fax:510-293-3023
Practice Address - Street 1:27489 PORTSMOUTH AVE
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545
Practice Address - Country:US
Practice Address - Phone:510-293-3023
Practice Address - Fax:510-293-3023
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIC HEALTH CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-16
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA020000649OtherMEDICAL CERTIFIED ICF