Healthcare Provider Details

I. General information

NPI: 1942763347
Provider Name (Legal Business Name): ARIZONA PERSONAL CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2019
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5134 N CENTRAL AVE STE 202
PHOENIX AZ
85012-1477
US

IV. Provider business mailing address

PO BOX 211706
ANCHORAGE AK
99521-1706
US

V. Phone/Fax

Practice location:
  • Phone: 907-727-4090
  • Fax:
Mailing address:
  • Phone: 907-727-4090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name: GANIYU SHITTU
Title or Position: PRESIDENT
Credential:
Phone: 727-722-6200