Healthcare Provider Details

I. General information

NPI: 1508002932
Provider Name (Legal Business Name): AMERICAN CARE HOMES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2009
Last Update Date: 01/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9859 S 46TH ST
PHOENIX AZ
85044-5534
US

IV. Provider business mailing address

3418 E INDIAN SCHOOL RD
PHOENIX AZ
85018-5113
US

V. Phone/Fax

Practice location:
  • Phone: 480-592-0058
  • Fax:
Mailing address:
  • Phone: 602-515-0783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberALH-6858
License Number StateAZ

VIII. Authorized Official

Name: MRS. ANDREA G. DATINGALING-PANALIGAN
Title or Position: C.E.O./PRESIDENT/OWNER
Credential: B.S.N., R.N.
Phone: 602-515-0783