Healthcare Provider Details
I. General information
NPI: 1659690865
Provider Name (Legal Business Name): CARING HANDS PEDIATRIC THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/27/2010
Last Update Date: 08/21/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1959 S. POWER RD STE 103-365
MESA AZ
85206-3768
US
IV. Provider business mailing address
1959 S. POWER RD STE 103-365
MESA AZ
85206-3768
US
V. Phone/Fax
- Phone: 480-518-1535
- Fax: 450-629-5443
- Phone: 480-518-1535
- Fax: 450-629-5443
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | SLP0533 |
| License Number State | AZ |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MS.
KATHERINE
L
SULSER
Title or Position: PREVIOUS OWNER
Credential: MA. CCC-SLP
Phone: 480-518-1535