Organization
AIDLIFE HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH LIGGAYU BSN-RN, PHN, PCCN (CHIEF OPERATING OFFICER)
(707) 515-8234
Entity
Organization
Contact information
Practice address
700 E ST STE 102-3, SAN RAFAEL, CA 94901-2762
(707) 641-6006
Mailing address
PO BOX 32663, SAN JOSE, CA 95152-2663
(707) 515-8234
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
372600000X
Adult Companion
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
484700029
CA HOME CARE SERVICES BRANCH
CA
Enumeration date
05/20/2024
Last updated
09/20/2024
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