=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770819435
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AA SENIOR CARE SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/30/2009
-----------------------------------------------------
Last Update Date | 02/23/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1106 N WALNUT AVE
-----------------------------------------------------
City | NEW BRAUNFELS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78130-5321
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 830-609-9128
-----------------------------------------------------
Fax | 830-609-9138
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1106 N WALNUT AVE
-----------------------------------------------------
City | NEW BRAUNFELS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78130-5321
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 830-609-9128
-----------------------------------------------------
Fax | 210-830-6099
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MRS. HELEN OLGA TROWSDALE
-----------------------------------------------------
Credential | R.N.
-----------------------------------------------------
Telephone | 210-508-7179
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------