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General NPI Number Information
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NPI Number | 1255172029
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Entity Type | Organization
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Legal Business Name | VALLEY RESPITE AND HOME CARE LLC
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 06/13/2024
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Provider Practice Location Address
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Address Line | 5640 W TRENTON WAY
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City | FLORENCE
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State | AZ
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Zip | 85132-1318
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Country | US
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Telephone | 520-340-4246
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Fax | 520-340-4254
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Provider Business Mailing Address
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Address Line | 5640 W TRENTON WAY
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City | FLORENCE
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State | AZ
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Zip | 85132-1318
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Country | US
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Telephone | 520-340-4246
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Fax | 520-340-4254
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Authorized Official
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Title or Position | MANAGER
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Name | VIRGINIA SIARA
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Credential |
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Telephone | 520-340-4246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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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 | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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