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General NPI Number Information
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NPI Number | 1134868995
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Entity Type | Organization
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Legal Business Name | NEXTCARE PROVIDERS LLC
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 2942 N 24TH ST STE 114-349
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City | PHOENIX
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State | AZ
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Zip | 85016-7878
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Country | US
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Telephone | 480-743-1205
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Fax | 480-666-6765
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Provider Business Mailing Address
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Address Line | 2942 N 24TH ST STE 114-349
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City | PHOENIX
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State | AZ
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Zip | 85016-7878
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Country | US
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Telephone | 480-743-1205
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Fax | 480-666-6765
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Authorized Official
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Title or Position | CEO
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Name | MR. WILLY NGANGA
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Credential |
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Telephone | 480-743-1205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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