Provider Demographics
NPI:1861505075
Name:AJR HOME CARE INC
Entity Type:Organization
Organization Name:AJR HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-319-2046
Mailing Address - Street 1:4815 NW 79TH AVE
Mailing Address - Street 2:UNIT 2
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-5437
Mailing Address - Country:US
Mailing Address - Phone:786-319-2046
Mailing Address - Fax:
Practice Address - Street 1:4815 NW 79TH AVE
Practice Address - Street 2:UNIT 2
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-5437
Practice Address - Country:US
Practice Address - Phone:786-319-2046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health