Healthcare Provider Details

I. General information

NPI: 1861172553
Provider Name (Legal Business Name): ANGELS COMFORT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3621 N 60TH AVE
PHOENIX AZ
85033-4628
US

IV. Provider business mailing address

3621 N 60TH AVE
PHOENIX AZ
85033-4628
US

V. Phone/Fax

Practice location:
  • Phone: 602-446-7745
  • Fax:
Mailing address:
  • Phone: 602-446-7745
  • 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 Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: ROCIO SOLIS
Title or Position: PRESIDENT/ADMIN
Credential:
Phone: 602-446-7745