Healthcare Provider Details

I. General information

NPI: 1225656994
Provider Name (Legal Business Name): MI SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2020
Last Update Date: 01/04/2022
Certification Date: 01/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 E COUNTRY CROSSING WAY
SAN TAN VLY AZ
85143-6184
US

IV. Provider business mailing address

64 W SUN RAY DR
SAN TAN VLY AZ
85143-4391
US

V. Phone/Fax

Practice location:
  • Phone: 480-536-2224
  • Fax:
Mailing address:
  • Phone: 623-250-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MARLEANA MARIE IVANOV
Title or Position: DIRECTOR
Credential:
Phone: 623-920-3893