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General NPI Number Information
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NPI Number | 1851107742
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Entity Type | Organization
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Legal Business Name | MAX HOMECARE LLC
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 19752 W BUCHANAN ST
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City | BUCKEYE
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State | AZ
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Zip | 85326-3054
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Country | US
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Telephone | 443-579-6210
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Fax |
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Provider Business Mailing Address
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Address Line | 4801 W KRALL ST
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City | GLENDALE
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State | AZ
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Zip | 85301-4165
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Country | US
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Telephone | 443-579-6210
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JUNE DAMEY
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Credential |
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Telephone | 443-579-6210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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