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General NPI Number Information
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NPI Number | 1245821404
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Entity Type | Organization
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Legal Business Name | INFINITYCARE LLC
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Dates
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Enumeration Date | 01/31/2021
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Last Update Date | 01/31/2021
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Provider Practice Location Address
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Address Line | 17156 W TONTO STREET GOODYEAR
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City | ARIZONA
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State | AZ
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Zip | 85338
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Country | US
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Telephone | 480-868-3982
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Fax |
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Provider Business Mailing Address
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Address Line | 17156 W TONTO STREET GOODYEAR
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City | ARIZONA
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State | AZ
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Zip | 85338
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Country | US
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Telephone | 480-868-3982
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ADERONKE ONI
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Credential |
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Telephone | 678-308-4254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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