Healthcare Provider Details

I. General information

NPI: 1487142394
Provider Name (Legal Business Name): AAA HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2018
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15509 N SCOTTSDALE RD UNIT 4047
SCOTTSDALE AZ
85254-3146
US

IV. Provider business mailing address

15509 N SCOTTSDALE RD UNIT 4047
SCOTTSDALE AZ
85254-3146
US

V. Phone/Fax

Practice location:
  • Phone: 704-309-8893
  • Fax:
Mailing address:
  • Phone: 704-309-8893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. SARAH PARSON
Title or Position: OWNER
Credential:
Phone: 704-309-8893