Healthcare Provider Details

I. General information

NPI: 1669628921
Provider Name (Legal Business Name): AIDE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 IRENE AVE.
IRONTON MN
56455
US

IV. Provider business mailing address

PO BOX 1
IRONTON MN
56455-0001
US

V. Phone/Fax

Practice location:
  • Phone: 218-546-6242
  • Fax: 218-546-6242
Mailing address:
  • Phone: 218-546-6242
  • Fax: 218-546-6242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DEBBIE EGAN
Title or Position: C.E.O.
Credential:
Phone: 218-546-6242