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General NPI Number Information
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NPI Number | 1437318847
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Entity Type | Organization
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Legal Business Name | AT YOUR DOOR ELDERCARE, LLC
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Dates
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Enumeration Date | 06/02/2008
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Last Update Date | 07/20/2010
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Provider Practice Location Address
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Address Line | 17035 N 67TH AVE SUITE 11
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City | GLENDALE
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State | AZ
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Zip | 85308-4511
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Country | US
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Telephone | 623-878-2885
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Fax | 623-878-6512
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Provider Business Mailing Address
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Address Line | 17035 N 67TH AVE SUITE 11
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City | GLENDALE
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State | AZ
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Zip | 85308-4511
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Country | US
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Telephone | 623-878-2885
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Fax | 623-878-6512
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Authorized Official
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Title or Position | OWNER
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Name | MS. REBECCA DANIELLE TANNER
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Credential |
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Telephone | 623-878-2885
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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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