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General NPI Number Information
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NPI Number | 1922444140
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Entity Type | Organization
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Legal Business Name | AVENTAS HOME HEALTH, LLC
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Dates
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Enumeration Date | 05/14/2013
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Last Update Date | 06/23/2014
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Provider Practice Location Address
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Address Line | 2193 N CAMINO PRINCIPAL SUITE # 161
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City | TUCSON
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State | AZ
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Zip | 85715-5336
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Country | US
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Telephone | 520-207-4111
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Fax | 520-207-5577
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Provider Business Mailing Address
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Address Line | 2193 N CAMINO PRINCIPAL SUITE # 161
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City | TUCSON
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State | AZ
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Zip | 85715-5336
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Country | US
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Telephone | 520-207-4111
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Fax | 520-207-5577
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. ANNE ELIZABETH RYAN
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Credential |
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Telephone | 520-207-4111
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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 | HHA5818
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License Number State | AZ
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