Provider Demographics
NPI:1124886452
Name:AIKO HOME CARE
Entity type:Organization
Organization Name:AIKO HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLESTON
Authorized Official - Middle Name:
Authorized Official - Last Name:CROUCH
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:917-565-1225
Mailing Address - Street 1:43 SWEETWATER BRIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-5597
Mailing Address - Country:US
Mailing Address - Phone:917-565-1225
Mailing Address - Fax:
Practice Address - Street 1:43 SWEETWATER BRIDGE TRL
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-5597
Practice Address - Country:US
Practice Address - Phone:917-565-1225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care