Provider Demographics
NPI:1710391263
Name:1 - & - 1 - AAA HOME CARE, INCORPORATED
Entity Type:Organization
Organization Name:1 - & - 1 - AAA HOME CARE, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:THAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-466-3196
Mailing Address - Street 1:PO BOX 1368
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83653-1368
Mailing Address - Country:US
Mailing Address - Phone:208-466-3196
Mailing Address - Fax:208-468-0510
Practice Address - Street 1:324 CALDWELL BLVD STE B
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-8409
Practice Address - Country:US
Practice Address - Phone:208-466-3196
Practice Address - Fax:208-468-0510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDM0026784Medicaid