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General NPI Number Information
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NPI Number | 1598814758
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL HOME CARE SERVICES, LLC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 09/13/2013
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Provider Practice Location Address
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Address Line | 7600 N 16TH ST SUITE 140
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City | PHOENIX
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State | AZ
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Zip | 85020-4431
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Country | US
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Telephone | 602-263-5000
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Fax | 602-263-5061
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Provider Business Mailing Address
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Address Line | 7600 N 16TH ST SUITE 140
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City | PHOENIX
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State | AZ
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Zip | 85020-4431
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Country | US
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Telephone | 602-263-5000
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Fax | 602-263-5061
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Authorized Official
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Title or Position | V.P. OPERATIONS
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Name | LAURA NICHOLS
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Credential |
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Telephone | 602-395-5100
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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 | HHA1950
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License Number State | AZ
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