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NPI Code Detail

MEDICARE: RESCARE ARIZONA, INC.

MEDICARE: RESCARE ARIZONA, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1315P00000XIntellectual Disabilities Intermediate Care Facility

General Provider Information

NPI Number : 1336513043
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESCARE ARIZONA, INC.
Provider Business Mailing Address
First Line : 9901 LINN STATION RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40223-3808
Country : US
Telephone Number : 502-394-2100
Fax Number :
Provider Business Practice Location Address
First Line : 413 E RODEO DR
Second Line :
City : TUCSON
State : AZ
Zip : 85714-2842
Country : US
Telephone Number : 520-327-1482
Fax Number :
Authorized Official
Title or Position : ASSOCIATE GENERAL COUNSEL
Name : MS. DEENA G. OMBRES
Credential :
Telephone Number : 502-394-2100
Provider Enumeration Date : 11/18/2015
Last Update Date : 11/18/2015

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