Healthcare Provider Details

I. General information

NPI: 1285356956
Provider Name (Legal Business Name): HUMAN CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 05/22/2024
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36550 W SANTA MARIA ST
MARICOPA AZ
85138-2139
US

IV. Provider business mailing address

36550 W SANTA MARIA ST
MARICOPA AZ
85138-2139
US

V. Phone/Fax

Practice location:
  • Phone: 805-636-0700
  • Fax:
Mailing address:
  • Phone: 805-636-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ANDREW REEVES
Title or Position: PRESIDENT
Credential:
Phone: 805-636-0700