Provider Demographics
NPI:1841810660
Name:AMIEDA SERVICES LLC
Entity type:Organization
Organization Name:AMIEDA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:SIMINIALAYI
Authorized Official - Last Name:JAJA PARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-670-5907
Mailing Address - Street 1:18302 PALISADE ROCK COURT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407
Mailing Address - Country:US
Mailing Address - Phone:832-670-5907
Mailing Address - Fax:
Practice Address - Street 1:18302 PALISADE ROCK COURT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407
Practice Address - Country:US
Practice Address - Phone:832-670-5907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty