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General NPI Number Information
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NPI Number | 1336722719
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Entity Type | Organization
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Legal Business Name | FAMILY CARE CONNECTIONS LLC
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Dates
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Enumeration Date | 05/03/2021
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Last Update Date | 05/03/2021
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Provider Practice Location Address
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Address Line | 17505 N 79TH AVE STE 103
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City | GLENDALE
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State | AZ
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Zip | 85308-8724
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Country | US
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Telephone | 623-776-9351
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Fax |
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Provider Business Mailing Address
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Address Line | 23620 N 102ND AVE
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City | PEORIA
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State | AZ
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Zip | 85383-2887
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Country | US
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Telephone | 623-776-9351
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. HEATHER LEIGH PAIGE
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Credential |
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Telephone | 623-776-9351
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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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