Healthcare Provider Details

I. General information

NPI: 1114663366
Provider Name (Legal Business Name): MARIA GLORIA SANCHEZ HOME HEALTH PROVIDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIA GLORIA SANCHEZ DIAZ LLC

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1632 W THUNDERBIRD RD
PHOENIX AZ
85023-6305
US

IV. Provider business mailing address

1632 W THUNDERBIRD RD
PHOENIX AZ
85023-6305
US

V. Phone/Fax

Practice location:
  • Phone: 148-066-7088
  • Fax:
Mailing address:
  • Phone: 148-066-7088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number86-1958212
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: