Provider Demographics
NPI:1821076332
Name:AIM HOME CARE INC WEST LA
Entity Type:Organization
Organization Name:AIM HOME CARE INC WEST LA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CEO PRESIDENT DIR OF NURSING
Authorized Official - Prefix:MS
Authorized Official - First Name:NATALYA
Authorized Official - Middle Name:
Authorized Official - Last Name:TSIKANOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-345-0545
Mailing Address - Street 1:5435 BALBOA BLVD
Mailing Address - Street 2:STE 105
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1587
Mailing Address - Country:US
Mailing Address - Phone:818-345-0545
Mailing Address - Fax:818-386-2451
Practice Address - Street 1:5435 BALBOA BLVD
Practice Address - Street 2:STE 105
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-1587
Practice Address - Country:US
Practice Address - Phone:818-345-0545
Practice Address - Fax:818-386-2451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA57591FMedicaid
CA557591Medicare Oscar/Certification