Provider Demographics
NPI:1437966314
Name:AZIZAS RESIDENTIAL CARE LLC
Entity type:Organization
Organization Name:AZIZAS RESIDENTIAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:
Authorized Official - First Name:CALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-793-8385
Mailing Address - Street 1:126 W CHANNING AVE
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-2729
Mailing Address - Country:US
Mailing Address - Phone:701-793-8385
Mailing Address - Fax:
Practice Address - Street 1:1820 39TH ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-7401
Practice Address - Country:US
Practice Address - Phone:701-793-8385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-14
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care