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General NPI Number Information
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NPI Number | 1275797169
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Entity Type | Organization
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Legal Business Name | PHOENIX VALLEY SENIOR CARE
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 1450 W GUADALUPE RD STE 115
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City | GILBERT
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State | AZ
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Zip | 85233-3042
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Country | US
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Telephone | 480-632-1100
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Fax | 480-632-0230
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Provider Business Mailing Address
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Address Line | 1450 W GUADALUPE RD STE 115
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City | GILBERT
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State | AZ
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Zip | 85233-3042
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Country | US
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Telephone | 480-632-1100
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Fax | 480-632-0230
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Authorized Official
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Title or Position | OWNER
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Name | MISS SHERRI LYNN TAYLOR
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Credential | RN
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Telephone | 480-632-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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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 | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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