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General NPI Number Information
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NPI Number | 1679635072
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Entity Type | Organization
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Legal Business Name | DYNA CARE ARIZONA LLC
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 12/02/2008
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Provider Practice Location Address
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Address Line | 1553 W TODD DR SUITE 101
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City | TEMPE
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State | AZ
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Zip | 85283-4805
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Country | US
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Telephone | 480-883-9295
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Fax | 480-883-9252
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Provider Business Mailing Address
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Address Line | 1201 S ALMA SCHOOL RD SUITE 7550
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City | MESA
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State | AZ
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Zip | 85210-2008
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ABITURAB R. BOXWALLA
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Credential |
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Telephone | 708-560-2925
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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 | HHA3390
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License Number State | AZ
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