Healthcare Provider Details

I. General information

NPI: 1700682911
Provider Name (Legal Business Name): AGE OF WISDOM SENIOR CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2025
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15411 W WADDELL RD STE 102
SURPRISE AZ
85379-5170
US

IV. Provider business mailing address

PO BOX 3801
ABILENE TX
79604-3801
US

V. Phone/Fax

Practice location:
  • Phone: 325-433-8485
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. VALARIE CRAWFORD
Title or Position: OWNER/CEO
Credential: FNP-C
Phone: 469-765-7751