Healthcare Provider Details

I. General information

NPI: 1689490773
Provider Name (Legal Business Name): AIDWELL HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2024
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19580 W INDIAN SCHOOL RD STE 105
BUCKEYE AZ
85396-2082
US

IV. Provider business mailing address

19580 W INDIAN SCHOOL RD STE 105
BUCKEYE AZ
85396-2082
US

V. Phone/Fax

Practice location:
  • Phone: 480-499-3499
  • Fax:
Mailing address:
  • Phone: 480-499-3499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: IRMA ANGELICA RODRIGUEZ-MORALEZ
Title or Position: CEO
Credential:
Phone: 602-460-9111