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General NPI Number Information
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NPI Number | 1801213368
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Entity Type | Organization
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Legal Business Name | MONTEVISTA HEALTH SERVICES, L.L.C.
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Dates
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Enumeration Date | 03/22/2014
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Last Update Date | 03/22/2014
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Provider Practice Location Address
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Address Line | 7971 N 53RD AVE # 106
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City | GLENDALE
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State | AZ
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Zip | 85301-8652
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Country | US
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Telephone | 602-918-8012
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Fax | 623-937-8334
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Provider Business Mailing Address
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Address Line | 22093 N 178TH AVE
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City | SURPRISE
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State | AZ
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Zip | 85387-9703
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Country | US
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Telephone | 602-918-8012
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Fax | 623-937-8334
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEVIN SELLERS
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Credential |
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Telephone | 602-918-8012
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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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