MEDICARE: A-PLUS CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310500000X	Mental Illness Intermediate Care Facility

General Provider Information

NPI Number	:	1760831507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A-PLUS CARE, LLC

Provider Business Mailing Address
First Line	:	1626 E DUST DEVIL DR
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85143-4447
Country	:	US
Telephone Number	:	480-809-3768
Fax Number	:	480-323-2758

Provider Business Practice Location Address
First Line	:	1626 E DUST DEVIL DR
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85143-4447
Country	:	US
Telephone Number	:	480-809-3768
Fax Number	:	480-323-2758

Authorized Official
Title or Position	:	PROGRAM ADMINISTRATOR
Name	:	KADJI TANYI
Credential	:
Telephone Number	:	404-637-6147

Provider Enumeration Date	:	06/11/2016
Last Update Date	:	06/11/2016

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Directions to “A-PLUS CARE, LLC ” Practice Location

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