Provider Demographics
NPI:1841702552
Name:AG HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:AG HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GALIZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-936-8842
Mailing Address - Street 1:PO BOX 1243
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96721-1243
Mailing Address - Country:US
Mailing Address - Phone:808-936-8842
Mailing Address - Fax:
Practice Address - Street 1:15-1780 28TH AVENUE
Practice Address - Street 2:
Practice Address - City:KEA'AU
Practice Address - State:HI
Practice Address - Zip Code:96749
Practice Address - Country:US
Practice Address - Phone:808-936-8842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-03
Last Update Date:2018-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health