Healthcare Provider Details

I. General information

NPI: 1922483007
Provider Name (Legal Business Name): VALLEY WIDE HOME HEALTH CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2015
Last Update Date: 07/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1862 N HIGLEY RD
MESA AZ
85205-3304
US

IV. Provider business mailing address

1862 N HIGLEY RD
MESA AZ
85205
US

V. Phone/Fax

Practice location:
  • Phone: 480-278-3698
  • Fax:
Mailing address:
  • Phone: 480-278-3698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

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

VIII. Authorized Official

Name: MR. SEAN CADY
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 480-278-3698