Healthcare Provider Details
I. General information
NPI: 1689316366
Provider Name (Legal Business Name): SIGNAL HOMECARE OF ARIZONA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/12/2022
Last Update Date: 04/12/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
21096 E SPARROW DR
QUEEN CREEK AZ
85142-1531
US
IV. Provider business mailing address
1525 S HIGLEY RD STE 104
GILBERT AZ
85296-5045
US
V. Phone/Fax
- Phone: 480-845-7998
- Fax: 480-546-3787
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHARON
DARROW
Title or Position: OWNER
Credential:
Phone: 480-845-7998