MEDICARE: COMMUNITY OF HELPING ANGELS, 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
2	376J00000X	Homemaker	UNLICENSED	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689668923
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY OF HELPING ANGELS, INC.

Provider Business Mailing Address
First Line	:	10240 N 31ST AVE
Second Line	:	SU. 114
City	:	PHOENIX
State	:	AZ
Zip	:	85051-9558
Country	:	US
Telephone Number	:	602-595-5129
Fax Number	:	602-938-3797

Provider Business Practice Location Address
First Line	:	10240 N 31ST AVE
Second Line	:	SU. 114
City	:	PHOENIX
State	:	AZ
Zip	:	85051-9558
Country	:	US
Telephone Number	:	602-595-5129
Fax Number	:	602-938-3797

Authorized Official
Title or Position	:	SECRETARY-TREASURER
Name	:	RICHARD KINGMAN DODGE
Credential	:	RN
Telephone Number	:	602-439-1528

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	09/11/2025

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