Healthcare Provider Details

I. General information

NPI: 1902620669
Provider Name (Legal Business Name): HANDLED HOME CARE LC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 N. CENTRAL AVE, 183 #4461
PHOENIX AZ
85012
US

IV. Provider business mailing address

3101 N. CENTRAL AVE, #4461 SUITE 183
PHOENIX AZ
85012
US

V. Phone/Fax

Practice location:
  • Phone: 602-456-5998
  • Fax:
Mailing address:
  • Phone: 602-456-5998
  • 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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL CHABABO
Title or Position: CARE COORDINATOR, OWNER
Credential:
Phone: 503-547-9324