Healthcare Provider Details

I. General information

NPI: 1225290224
Provider Name (Legal Business Name): RLJ ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2990 N LITCHFIELD RD SUITE 106
GOODYEAR AZ
85395-7800
US

IV. Provider business mailing address

2990 N LITCHFIELD RD SUITE 106
GOODYEAR AZ
85395-7800
US

V. Phone/Fax

Practice location:
  • Phone: 623-935-9961
  • Fax: 623-935-9976
Mailing address:
  • Phone: 623-935-9961
  • Fax: 623-935-9976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateAZ

VIII. Authorized Official

Name: RAY JOHNSON
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 623-935-9961