Healthcare Provider Details

I. General information

NPI: 1457025009
Provider Name (Legal Business Name): THE JOHN AND JOSEPHINE ROSE LIVING NETWORK FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

Provider Other Name: AVION HEALTHCARE

II. Dates (important events)

Enumeration Date: 08/06/2021
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5541 E GRANT RD
TUCSON AZ
85712-2209
US

IV. Provider business mailing address

5541 E GRANT RD
TUCSON AZ
85712-2209
US

V. Phone/Fax

Practice location:
  • Phone: 520-204-7958
  • Fax:
Mailing address:
  • Phone: 520-204-7958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2400X
TaxonomyPrison Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: JAMES JOSEPH ROSE
Title or Position: PRESIDENT/CEO
Credential: CFLE
Phone: 520-704-8310