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General NPI Number Information
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NPI Number | 1821606708
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Entity Type | Organization
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Legal Business Name | AIMOAK PERSONALIZED CARE LLC
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Dates
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Enumeration Date | 07/16/2020
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Last Update Date | 01/13/2021
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Provider Practice Location Address
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Address Line | 131 E MAIN ST
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City | BROWNSVILLE
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State | TN
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Zip | 38012-2144
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Country | US
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Telephone | 615-495-7760
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Fax |
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Provider Business Mailing Address
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Address Line | 131 E MAIN ST
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City | BROWNSVILLE
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State | TN
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Zip | 38012-2144
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Country | US
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Telephone | 731-741-4363
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE DIRECTOR
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Name | KWAGHDOO ATSOR BOSSUAH
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Credential | APRN
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Telephone | 731-741-4363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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