Healthcare Provider Details

I. General information

NPI: 1609714500
Provider Name (Legal Business Name): COTTAGE HOME CARE AZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 N 3RD ST STE B300
PHOENIX AZ
85004-1471
US

IV. Provider business mailing address

2025 N 3RD ST STE B300
PHOENIX AZ
85004-1471
US

V. Phone/Fax

Practice location:
  • Phone: 480-885-2636
  • Fax:
Mailing address:
  • Phone: 480-885-2636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: ALLEN STEIN
Title or Position: OWNER
Credential:
Phone: 480-885-2636