MEDICARE: ARIZONA INDEPENDENCE & ABILITY SERVICES, 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1811850563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA INDEPENDENCE & ABILITY SERVICES, LLC

Provider Business Mailing Address
First Line	:	2800 N ARIZONA AVE APT 279
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85225-1978
Country	:	US
Telephone Number	:	480-818-9397
Fax Number	:

Provider Business Practice Location Address
First Line	:	4539 N 22ND ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4639
Country	:	US
Telephone Number	:	480-818-9397
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DELDRYA PUGH
Credential	:
Telephone Number	:	480-818-1939

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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