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General NPI Number Information
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NPI Number | 1437924321
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Entity Type | Organization
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Legal Business Name | INFINITY LIFE HOME CARE
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 1600 W LA JOLLA DR APT 2034
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City | TEMPE
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State | AZ
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Zip | 85282-4460
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Country | US
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Telephone | 148-022-8163
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 W LA JOLLA DR APT 2034
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City | TEMPE
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State | AZ
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Zip | 85282-4460
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Country | US
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Telephone | 602-817-8063
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JAYLA SHY'ANN HUGHES
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Credential |
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Telephone | 602-817-8063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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