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General NPI Number Information
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NPI Number | 1669218160
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL HEALTHCARE, LLC
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Dates
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Enumeration Date | 07/03/2024
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 1018 GRANDIFLORA DR STE B
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City | LELAND
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State | NC
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Zip | 28451-9328
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Country | US
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Telephone | 910-636-5575
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Fax | 910-218-3797
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Provider Business Mailing Address
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Address Line | 2999 N 44TH ST STE 100
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City | PHOENIX
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State | AZ
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Zip | 85018-7247
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Country | US
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Telephone | 806-185-7604
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Fax | 602-253-5656
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MIKE LOVELL
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Credential |
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Telephone | 480-618-5760
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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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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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