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General NPI Number Information
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NPI Number | 1750794103
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Entity Type | Organization
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Legal Business Name | HONORA HEALTHCARE SERVICES, LLC.
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 06/03/2014
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Provider Practice Location Address
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Address Line | 60 E RIO SALADO PKWY SUITE 900
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City | TEMPE
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State | AZ
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Zip | 85281-9124
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Country | US
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Telephone | 602-330-3472
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Fax | 888-818-4521
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Provider Business Mailing Address
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Address Line | 60 E RIO SALADO PKWY SUITE 900
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City | TEMPE
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State | AZ
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Zip | 85281-9124
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Country | US
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Telephone | 602-330-3472
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Fax | 888-818-4521
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | SAMSON FOLORUNSO OMOSOWON
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Credential | RN
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Telephone | 480-335-3099
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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 | RN156392
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License Number State | AZ
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