Healthcare Provider Details

I. General information

NPI: 1003560152
Provider Name (Legal Business Name): AFFIRMA HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2022
Last Update Date: 02/12/2022
Certification Date: 02/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7784 N 57TH DR
GLENDALE AZ
85301-7869
US

IV. Provider business mailing address

7784 N 57TH DR
GLENDALE AZ
85301-7869
US

V. Phone/Fax

Practice location:
  • Phone: 602-380-2195
  • Fax: 602-944-2527
Mailing address:
  • Phone: 602-380-2195
  • Fax: 602-944-2527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: SARAH BANSUAN ARABIT
Title or Position: MANAGER
Credential: NP
Phone: 602-380-2195