Provider Demographics
NPI:1821606708
Name:AIMOAK PERSONALIZED CARE LLC
Entity Type:Organization
Organization Name:AIMOAK PERSONALIZED CARE LLC
Other - Org Name:AIM OAK HEALTHCARE SERVICES DBA TRI-COUNTY VISITING NURSES LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ASSOCIATE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KWAGHDOO
Authorized Official - Middle Name:ATSOR
Authorized Official - Last Name:BOSSUAH
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:731-741-4363
Mailing Address - Street 1:131 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38012-2144
Mailing Address - Country:US
Mailing Address - Phone:731-741-4363
Mailing Address - Fax:
Practice Address - Street 1:131 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38012-2144
Practice Address - Country:US
Practice Address - Phone:615-495-7760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-16
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage
No251E00000XAgenciesHome Health