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General NPI Number Information
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NPI Number | 1568433969
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Entity Type | Organization
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Legal Business Name | ARIZONA HOME CARE LLC
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 10/21/2015
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Provider Practice Location Address
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Address Line | 1626 S EDWARD DRIVE
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City | TEMPE
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State | AZ
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Zip | 85281
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Country | US
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Telephone | 602-252-5000
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Fax | 602-323-5070
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Provider Business Mailing Address
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Address Line | 1626 S EDWARD DRIVE
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City | TEMPE
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State | AZ
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Zip | 85281
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Country | US
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Telephone | 602-252-5000
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Fax | 602-323-5070
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Authorized Official
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Title or Position | COO
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Name | MR. JASON ALLEN SMIDT
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Credential |
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Telephone | 480-246-3968
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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 | HHA0268
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License Number State | AZ
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