Healthcare Provider Details
I. General information
NPI: 1386993004
Provider Name (Legal Business Name): VALLEY CARE & ENRICHMENT SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/10/2012
Last Update Date: 09/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2117 SOUTH 48TH STREET # 103
TEMPE AZ
85282
US
IV. Provider business mailing address
2117 S 48TH ST STE 103
TEMPE AZ
85282-1016
US
V. Phone/Fax
- Phone: 602-437-0106
- Fax: 602-437-0109
- Phone: 602-437-0106
- Fax: 602-437-0109
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2065X |
| Taxonomy | Child Physical Disabilities Respite Care |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ABDELRAHIM
ABDELRAHMAN
Title or Position: CEO
Credential:
Phone: 602-437-0106