MEDICARE: ITC PERSONAL IN-HOME CARE LLC

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	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care	479687	AZ

General Provider Information

NPI Number	:	1699023846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ITC PERSONAL IN-HOME CARE LLC

Provider Business Mailing Address
First Line	:	1345 E MAIN ST STE 110
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85203-8950
Country	:	US
Telephone Number	:	480-969-5480
Fax Number	:	480-969-5512

Provider Business Practice Location Address
First Line	:	1345 E MAIN ST STE 110
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85203-8950
Country	:	US
Telephone Number	:	480-969-5480
Fax Number	:	480-969-5512

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JOSH GONZALES
Credential	:
Telephone Number	:	480-969-5480

Provider Enumeration Date	:	08/20/2012
Last Update Date	:	08/20/2012

Similar Medicare Providers

1699626713 — ROYA HEALTH, LLC
Practice Location Address:

1345 E MAIN ST STE 104
MESA, AZ
85203-8950

Practice Phone: 480-300-4741
Practice Fax:

1083805030 — HAPPY KIDS PEDIATRICS P.C.
Practice Location Address:

1345 E MAIN ST STE 103
MESA, AZ
85203-8950

Practice Phone: 480-223-0290
Practice Fax:

1538533799 — FELIZ FAMILY CARE, PLLC
Practice Location Address:

1345 E MAIN ST STE 100
MESA, AZ
85203-8950

Practice Phone: 480-264-3711
Practice Fax: 480-272-7580

1427768480 — DULCE C USECHE DE MUJICA PHYSICIAN ASSISTANT
Practice Location Address:

1345 E MAIN ST STE 100
MESA, AZ
85203-8950

Practice Phone: 480-264-3711
Practice Fax: 877-725-3934

1144902032 — SUNTCHYL GILLES
Practice Location Address:

1345 E MAIN ST STE 103
MESA, AZ
85203-8950

Practice Phone: 480-223-0290
Practice Fax:

1316798341 — JACQUELINE DANETH VARELA-MANRIQUEZ
Practice Location Address:

1345 E MAIN ST STE 104
MESA, AZ
85203-8950

Practice Phone: 602-785-3133
Practice Fax:

Directions to “ITC PERSONAL IN-HOME CARE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.