Provider Demographics
NPI:1740056803
Name:AIAA ENTERPRISE LLC
Entity type:Organization
Organization Name:AIAA ENTERPRISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RHEA
Authorized Official - Middle Name:CRUZ
Authorized Official - Last Name:MAGPANTAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-563-7505
Mailing Address - Street 1:2500 E FOOTHILL BLVD STE 404
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-7123
Mailing Address - Country:US
Mailing Address - Phone:626-563-7505
Mailing Address - Fax:
Practice Address - Street 1:2500 E FOOTHILL BLVD STE 404
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-7123
Practice Address - Country:US
Practice Address - Phone:626-563-7505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care