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General NPI Number Information
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NPI Number | 1346745072
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Entity Type | Organization
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Legal Business Name | WATERSHED FINANCIAL, LLC
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 7702 E DOUBLETREE RANCH RD STE 300
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-2132
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Country | US
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Telephone | 602-672-4818
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Fax | 480-522-1444
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Provider Business Mailing Address
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Address Line | 7702 E DOUBLETREE RANCH RD STE 300
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-2132
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Country | US
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Telephone | 602-672-4818
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Fax | 480-522-1444
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | MR. NAJIB HODGE
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Credential |
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Telephone | 602-672-4818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 320295
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 320295
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License Number State | AZ
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