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General NPI Number Information
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NPI Number | 1508276049
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Entity Type | Organization
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Legal Business Name | TIGER CARE LLC
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Dates
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Enumeration Date | 05/06/2014
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Last Update Date | 05/06/2014
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Provider Practice Location Address
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Address Line | 2111 E BROADWAY RD STE 15
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City | TEMPE
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State | AZ
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Zip | 85282-1736
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Country | US
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Telephone | 480-466-2973
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Fax |
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Provider Business Mailing Address
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Address Line | 2111 E BROADWAY RD STE 15
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City | TEMPE
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State | AZ
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Zip | 85282-1736
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WAIEL IBRAHIM
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Credential |
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Telephone | 480-466-2973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State | AZ
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