Healthcare Provider Details

I. General information

NPI: 1205352176
Provider Name (Legal Business Name): LINTOC CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 08/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3707 E SOUTHERN AVENUE SUITE 1017
MESA AZ
85206
US

IV. Provider business mailing address

3707 E SOUTHERN AVE STE 1017
MESA AZ
85206-6201
US

V. Phone/Fax

Practice location:
  • Phone: 480-678-6047
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA8407
License Number StateAZ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: TOCHUKWU OKAFOR
Title or Position: CEO
Credential:
Phone: 480-678-6047