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General NPI Number Information
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NPI Number | 1225358591
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Entity Type | Organization
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Legal Business Name | ALL VALLEY NURSING LLC
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Dates
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Enumeration Date | 06/09/2010
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 4531 N 16TH ST SUITE 114
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City | PHOENIX
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State | AZ
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Zip | 85016-5322
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Country | US
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Telephone | 602-889-5308
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Fax |
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Provider Business Mailing Address
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Address Line | 7227 N 16TH ST SUITE 125
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City | PHOENIX
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State | AZ
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Zip | 85020-5251
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | DARRELL DIERKS
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Credential | RN
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Telephone | 623-889-5308
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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 | HHA 4744
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License Number State | AZ
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