Healthcare Provider Details

I. General information

NPI: 1669004560
Provider Name (Legal Business Name): ANOD CARE SERVICES,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2020
Last Update Date: 02/07/2020
Certification Date: 02/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4742 N 24TH ST STE 300
PHOENIX AZ
85016-9107
US

IV. Provider business mailing address

4742 N 24TH ST STE 300
PHOENIX AZ
85016-9107
US

V. Phone/Fax

Practice location:
  • Phone: 952-486-1049
  • Fax:
Mailing address:
  • Phone: 952-486-1049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: HURRE R KOJE
Title or Position: CEO
Credential:
Phone: 952-486-1049