Provider Demographics
NPI:1376375311
Name:AJAC HOMECARE INC.
Entity type:Organization
Organization Name:AJAC HOMECARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:U
Authorized Official - Last Name:OGUNJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-721-0321
Mailing Address - Street 1:1851 HUNTINGTON DR STE 89-69
Mailing Address - Street 2:
Mailing Address - City:DUARTE
Mailing Address - State:CA
Mailing Address - Zip Code:91010-2635
Mailing Address - Country:US
Mailing Address - Phone:626-721-0321
Mailing Address - Fax:
Practice Address - Street 1:1851 HUNTINGTON DR STE 89-69
Practice Address - Street 2:
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-2635
Practice Address - Country:US
Practice Address - Phone:626-721-0321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care