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General NPI Number Information
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NPI Number | 1841702552
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Entity Type | Organization
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Legal Business Name | AG HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 11/03/2017
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Last Update Date | 06/23/2018
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Provider Practice Location Address
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Address Line | 15-1780 28TH AVENUE
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City | KEA'AU
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State | HI
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Zip | 96749
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Country | US
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Telephone | 808-936-8842
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1243
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City | HILO
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State | HI
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Zip | 96721-1243
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Country | US
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Telephone | 808-936-8842
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | JOANNA MARIE GALIZA
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Credential |
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Telephone | 808-936-8842
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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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