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General NPI Number Information
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NPI Number | 1497995526
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Entity Type | Organization
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Legal Business Name | PHOENIX CARE SERVICE, LLC
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Dates
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Enumeration Date | 03/02/2009
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Last Update Date | 03/02/2009
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Provider Practice Location Address
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Address Line | 2301 W DUNLAP AVE SUITE 114
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City | PHOENIX
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State | AZ
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Zip | 85021-2844
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Country | US
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Telephone | 602-944-0100
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Fax | 602-997-2499
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Provider Business Mailing Address
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Address Line | 2301 W DUNLAP AVE SUITE 114
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City | PHOENIX
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State | AZ
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Zip | 85021-2844
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Country | US
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Telephone | 602-944-0100
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Fax | 602-997-2499
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. JANE F. DAUME
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Credential |
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Telephone | 602-944-0100
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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 | AZ
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