Healthcare Provider Details

I. General information

NPI: 1083522692
Provider Name (Legal Business Name): HONORABLES HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

642 S MARVIN AVE
TUCSON AZ
85710-4918
US

IV. Provider business mailing address

642 S MARVIN AVE
TUCSON AZ
85710-4918
US

V. Phone/Fax

Practice location:
  • Phone: 520-278-8542
  • Fax:
Mailing address:
  • Phone: 520-278-8542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: NICOLINE JINGWA NJIKEM EPSE MOLONG
Title or Position: ADMINISTRATOR
Credential: BHT
Phone: 520-278-8542