Provider Demographics
NPI:1740801505
Name:AAA AMERICAN HEALTHCARE LLC
Entity Type:Organization
Organization Name:AAA AMERICAN HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:STIBAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-538-3122
Mailing Address - Street 1:665 JOHN ADAMS PKWY
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401-4072
Mailing Address - Country:US
Mailing Address - Phone:208-419-0144
Mailing Address - Fax:
Practice Address - Street 1:1301 E 17TH ST
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-6273
Practice Address - Country:US
Practice Address - Phone:208-538-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management