Healthcare Provider Details

I. General information

NPI: 1891616249
Provider Name (Legal Business Name): AREA AGENCY ON AGING, REGION ONE, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1366 E THOMAS RD STE 108
PHOENIX AZ
85014-5739
US

IV. Provider business mailing address

1366 E THOMAS RD STE 108
PHOENIX AZ
85014-5739
US

V. Phone/Fax

Practice location:
  • Phone: 602-264-2255
  • Fax: 602-230-9132
Mailing address:
  • Phone: 602-264-2255
  • Fax: 602-230-9132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: MARY LYNN KASUNIC
Title or Position: PRESIDENT & CEO
Credential:
Phone: 602-264-2255