1477130441 NPI number — ARAA HOME CARE, LLC

Table of content: (NPI 1477130441)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477130441 NPI number — ARAA HOME CARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARAA HOME CARE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477130441
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5331 PRIMROSE LAKE CIR STE 219
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33647-3751
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-953-1030
Provider Business Mailing Address Fax Number:
678-466-8343

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5331 PRIMROSE LAKE CIR STE 219
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33647-3751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-953-1030
Provider Business Practice Location Address Fax Number:
678-466-8343
Provider Enumeration Date:
03/25/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BAXTER
Authorized Official First Name:
KENDRA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
813-304-7546

Provider Taxonomy Codes

  • Taxonomy code: 251J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1376179705 , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".