Healthcare Provider Details

I. General information

NPI: 1104703941
Provider Name (Legal Business Name): AZURA HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2025
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 N CENTRAL AVE STE 1000
PHOENIX AZ
85004-1027
US

IV. Provider business mailing address

2828 N CENTRAL AVE STE 1000
PHOENIX AZ
85004-1027
US

V. Phone/Fax

Practice location:
  • Phone: 216-798-3926
  • Fax:
Mailing address:
  • Phone: 623-462-3131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: LATANYA WILLIS
Title or Position: CEO
Credential:
Phone: 216-798-3926