Healthcare Provider Details

I. General information

NPI: 1114845898
Provider Name (Legal Business Name): OLIMPIA'S HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2517 W BARBIE LN
PHOENIX AZ
85085-5007
US

IV. Provider business mailing address

2517 W BARBIE LN
PHOENIX AZ
85085-5007
US

V. Phone/Fax

Practice location:
  • Phone: 503-351-5775
  • Fax: 220-241-7659
Mailing address:
  • Phone: 503-351-5775
  • Fax: 220-241-7659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: JORDAN R BELTZ
Title or Position: OWNER
Credential:
Phone: 503-351-5775