Provider Demographics
NPI:1689352197
Name:AMA HOME CARE LLC
Entity Type:Organization
Organization Name:AMA HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALIOUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:THIAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-939-9047
Mailing Address - Street 1:4321 W COLLEGE AVE APT SUITE200
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-3966
Mailing Address - Country:US
Mailing Address - Phone:920-939-9047
Mailing Address - Fax:
Practice Address - Street 1:N9353 S. LAKE PARK RD.
Practice Address - Street 2:124
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915
Practice Address - Country:US
Practice Address - Phone:920-939-9047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home