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General NPI Number Information
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NPI Number | 1235092313
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Entity Type | Organization
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Legal Business Name | SISISELA FRIENDLY HOME CARE
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 3056 E KRAMER ST
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City | MESA
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State | AZ
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Zip | 85213-3110
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Country | US
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Telephone | 480-453-4619
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Fax |
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Provider Business Mailing Address
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Address Line | 6144 E MINTON PL
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City | MESA
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State | AZ
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Zip | 85215-1516
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Country | US
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Telephone | 480-453-4619
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LUISA P FAINU
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Credential |
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Telephone | 480-453-4619
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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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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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