Healthcare Provider Details

I. General information

NPI: 1942163043
Provider Name (Legal Business Name): A&A HOMECARE PROFESSIONAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2249 N ZIRCON AVE
MERIDIAN ID
83646-3479
US

IV. Provider business mailing address

2249 N ZIRCON AVE
MERIDIAN ID
83646-3479
US

V. Phone/Fax

Practice location:
  • Phone: 208-490-1716
  • Fax:
Mailing address:
  • Phone: 208-490-1716
  • Fax: 208-490-1716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ALIA Z ALASMAR
Title or Position: OWNER
Credential:
Phone: 208-490-1716