Healthcare Provider Details

I. General information

NPI: 1245006766
Provider Name (Legal Business Name): MI FAMILIA HEALTHCARE AGENCY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1239 W CASTLE DR
CASA GRANDE AZ
85122-6652
US

IV. Provider business mailing address

1239 W CASTLE DR
CASA GRANDE AZ
85122-6652
US

V. Phone/Fax

Practice location:
  • Phone: 520-518-0844
  • Fax: 877-316-5145
Mailing address:
  • Phone: 520-518-0844
  • Fax: 877-316-5145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA JEFFERSON
Title or Position: FOUNDER
Credential:
Phone: 520-518-0844