Healthcare Provider Details

I. General information

NPI: 1750618575
Provider Name (Legal Business Name): ATTENTION HOME CARE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2009
Last Update Date: 12/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 E MCKELLIPS RD
MESA AZ
85203-2534
US

IV. Provider business mailing address

605 E MCKELLIPS RD
MESA AZ
85203-2534
US

V. Phone/Fax

Practice location:
  • Phone: 480-889-4611
  • Fax: 480-464-1799
Mailing address:
  • Phone: 480-889-4611
  • Fax: 480-464-1799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: RAE BETH YOUNG
Title or Position: OWNER
Credential:
Phone: 480-889-4611