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General NPI Number Information
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NPI Number | 1750520763
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Entity Type | Organization
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Legal Business Name | NATIVEAZ LLC
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Dates
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Enumeration Date | 02/13/2009
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Last Update Date | 02/13/2009
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Provider Practice Location Address
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Address Line | 5470 S LAKESHORE DR STE 101
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City | TEMPE
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State | AZ
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Zip | 85283-2173
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Country | US
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Telephone | 480-446-0767
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Fax | 480-247-5299
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Provider Business Mailing Address
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Address Line | 5470 S LAKESHORE DR STE 101
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City | TEMPE
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State | AZ
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Zip | 85283-2173
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Country | US
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Telephone | 480-446-0767
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Fax | 480-247-5299
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Authorized Official
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Title or Position | MEMBER/OWNER
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Name | MS. CONNIE S. THOMPSON
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Credential | R.N.
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Telephone | 480-446-0767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | N/A
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License Number State | AZ
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