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General NPI Number Information
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NPI Number | 1477148351
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Entity Type | Organization
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Legal Business Name | LIVING FREE TO BE US HOUSING AND HOME CARE LLC
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Dates
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Enumeration Date | 03/03/2021
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Last Update Date | 03/03/2021
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Provider Practice Location Address
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Address Line | 10401 N CAVE CREEK RD LOT 310
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City | PHOENIX
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State | AZ
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Zip | 85020-1601
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Country | US
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Telephone | 623-221-3625
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Fax |
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Provider Business Mailing Address
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Address Line | 10401 N CAVE CREEK RD LOT 310
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City | PHOENIX
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State | AZ
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Zip | 85020-1601
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Country | US
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Telephone | 623-221-3625
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | BEVERLY A PETERSON
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Credential | LNA
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Telephone | 623-221-3625
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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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