Provider Demographics
NPI:1831498583
Name:AANDDHOMEHEALTHCARELLC
Entity Type:Organization
Organization Name:AANDDHOMEHEALTHCARELLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN /DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:480-580-4265
Mailing Address - Street 1:PO BOX 2193
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85372-2193
Mailing Address - Country:US
Mailing Address - Phone:480-580-4265
Mailing Address - Fax:
Practice Address - Street 1:10636 W DEANNE DR
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-4451
Practice Address - Country:US
Practice Address - Phone:480-580-4265
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health