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General NPI Number Information
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NPI Number | 1619427283
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Entity Type | Organization
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Legal Business Name | ADVISACARE SOLUTIONS OF ARIZONA, LLC
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Dates
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Enumeration Date | 10/07/2016
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 3602 E GREENWAY RD STE 104
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City | PHOENIX
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State | AZ
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Zip | 85032-4648
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Country | US
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Telephone | 623-271-9755
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Fax | 623-271-9756
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Provider Business Mailing Address
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Address Line | 4234 CASCADE RD SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-8384
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Country | US
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Telephone | 623-271-9755
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Fax | 623-271-9756
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Authorized Official
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Title or Position | PRESIDENT
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Name | KRISTIAN SKOGEN
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Credential |
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Telephone | 623-271-9755
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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 |
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