Healthcare Provider Details

I. General information

NPI: 1275346124
Provider Name (Legal Business Name): A HOPEFUL HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18444 N 25TH AVE
PHOENIX AZ
85023-1261
US

IV. Provider business mailing address

1776 N SCOTTSDALE RD # 776
SCOTTSDALE AZ
85257-2115
US

V. Phone/Fax

Practice location:
  • Phone: 480-604-4859
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: TISHA GREEN
Title or Position: OWNER
Credential:
Phone: 480-702-6945