MEDICARE: MISSIONARY HOME HEALTH AND STAFFING 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
1	251E00000X	Home Health Agency		AZ

General Provider Information

NPI Number	:	1518160324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MISSIONARY HOME HEALTH AND STAFFING INC

Provider Business Mailing Address
First Line	:	4045 N 7TH ST STE 204A
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-4753
Country	:	US
Telephone Number	:	602-265-3830
Fax Number	:	602-265-3850

Provider Business Practice Location Address
First Line	:	4045 N 7TH ST STE 204A
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-4753
Country	:	US
Telephone Number	:	602-265-3830
Fax Number	:	602-265-3850

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. PATRICIA IBEABUCHI
Credential	:	RN
Telephone Number	:	602-265-3830

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	08/22/2020

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