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General NPI Number Information
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NPI Number | 1689352197
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Entity Type | Organization
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Legal Business Name | AMA HOME CARE LLC
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Dates
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Enumeration Date | 07/06/2023
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Last Update Date | 07/06/2023
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Provider Practice Location Address
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Address Line | N9353 S. LAKE PARK RD. 124
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City | APPLETON
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State | WI
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Zip | 54915
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Country | US
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Telephone | 920-939-9047
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Fax |
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Provider Business Mailing Address
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Address Line | 4321 W COLLEGE AVE APT SUITE200
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City | APPLETON
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State | WI
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Zip | 54914-3966
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Country | US
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Telephone | 920-939-9047
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MR. ALIOUNE THIAM
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Credential |
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Telephone | 920-939-9047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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