Healthcare Provider Details

I. General information

NPI: 1235044843
Provider Name (Legal Business Name): AAA IN HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62825 NE CRANBROOK PL
BEND OR
97701-3400
US

IV. Provider business mailing address

62825 NE CRANBROOK PL
BEND OR
97701-3400
US

V. Phone/Fax

Practice location:
  • Phone: 541-362-1369
  • Fax:
Mailing address:
  • Phone: 541-362-1369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: PARKER RANDELS
Title or Position: ADMINISTRATOR
Credential:
Phone: 405-664-0485