Healthcare Provider Details

I. General information

NPI: 1093977092
Provider Name (Legal Business Name): SIMCHAH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8601 N BLACK CANYON HWY SUITE 208
PHOENIX AZ
85021-4109
US

IV. Provider business mailing address

8601 N BLACK CANYON HWY SUITE 208
PHOENIX AZ
85021-4109
US

V. Phone/Fax

Practice location:
  • Phone: 602-595-1539
  • Fax: 602-513-7216
Mailing address:
  • Phone: 602-595-1539
  • Fax: 602-513-7216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: AMY L FARLEY
Title or Position: OWNER
Credential:
Phone: 602-595-1539