Healthcare Provider Details

I. General information

NPI: 1245224096
Provider Name (Legal Business Name): HOME HEALTH AGENCY - ARIZONA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2999 N 44TH ST STE 100
PHOENIX AZ
85018-7247
US

IV. Provider business mailing address

2999 N 44TH ST STE 100
PHOENIX AZ
85018-7247
US

V. Phone/Fax

Practice location:
  • Phone: 480-618-5760
  • Fax: 602-786-7719
Mailing address:
  • Phone: 602-382-8500
  • Fax: 602-253-5656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA3590
License Number StateAZ

VIII. Authorized Official

Name: SUSAN VALOCCHI
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 480-618-5760