Provider Demographics
NPI:1609310218
Name:AA SENIOR LIVING AND TOTAL CARE LLC
Entity Type:Organization
Organization Name:AA SENIOR LIVING AND TOTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AKHTAR
Authorized Official - Middle Name:
Authorized Official - Last Name:AKHTARUZZAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-951-8158
Mailing Address - Street 1:37 S MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:WILLISTON
Mailing Address - State:FL
Mailing Address - Zip Code:32696-2681
Mailing Address - Country:US
Mailing Address - Phone:352-505-7440
Mailing Address - Fax:
Practice Address - Street 1:37 S MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:WILLISTON
Practice Address - State:FL
Practice Address - Zip Code:32696-2681
Practice Address - Country:US
Practice Address - Phone:352-505-7440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty