Provider Demographics
NPI:1396969382
Name:AID & ASSISTANCE HOME CARE PROF.
Entity type:Organization
Organization Name:AID & ASSISTANCE HOME CARE PROF.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-218-1400
Mailing Address - Street 1:491 ATLANTA ST SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-2257
Mailing Address - Country:US
Mailing Address - Phone:770-218-1400
Mailing Address - Fax:770-218-1080
Practice Address - Street 1:491 ATLANTA ST SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-2257
Practice Address - Country:US
Practice Address - Phone:770-218-1400
Practice Address - Fax:770-218-1080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033-R-0040251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health