Healthcare Provider Details

I. General information

NPI: 1124458005
Provider Name (Legal Business Name): AIDE HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2013
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 4TH ST
IRONTON MN
56455-2214
US

IV. Provider business mailing address

312 4TH ST. P.O. BOX 1
IRONTON MN
56455
US

V. Phone/Fax

Practice location:
  • Phone: 218-772-0325
  • Fax: 218-772-0326
Mailing address:
  • Phone: 218-772-0325
  • Fax: 218-772-0326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number363348
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. DEBBIE ANN EGAN
Title or Position: CHEIF FINANCIAL OFFICER
Credential:
Phone: 218-546-6242