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General NPI Number Information
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NPI Number | 1568457612
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Entity Type | Organization
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Legal Business Name | PAYSON HOME CARE SERVICES LLC
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 06/23/2015
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Provider Practice Location Address
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Address Line | 708 E STATE HIGHWAY 260 STE A1
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City | PAYSON
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State | AZ
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Zip | 85541-4969
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Country | US
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Telephone | 928-472-5245
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Fax | 928-472-5250
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Provider Business Mailing Address
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Address Line | 708 E STATE HIGHWAY 260 STE A1
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City | PAYSON
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State | AZ
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Zip | 85541-4969
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Country | US
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Telephone | 928-472-5245
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Fax | 928-472-5250
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS OFFICE SUPPORT
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Name | MS. LAURIE HOLTSFORD
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Credential |
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Telephone | 615-465-7466
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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 | HHA0139
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License Number State | AZ
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