Provider Demographics
NPI:1114761897
Name:AMAIKAH HOME CARE LLC
Entity type:Organization
Organization Name:AMAIKAH HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:ACOB
Authorized Official - Last Name:BAGAOISAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-742-1126
Mailing Address - Street 1:971 CALLE PILARES
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-3329
Mailing Address - Country:US
Mailing Address - Phone:619-742-1126
Mailing Address - Fax:
Practice Address - Street 1:15158 JENELL ST
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2616
Practice Address - Country:US
Practice Address - Phone:619-742-1126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility