MEDICARE: CARE EXCELLENCE HOME HEALTH AND SUPPORTIVE SERVICES

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	385H00000X	Respite Care
2	171M00000X	Case Manager/Care Coordinator

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790098481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE EXCELLENCE HOME HEALTH AND SUPPORTIVE SERVICES

Provider Business Mailing Address
First Line	:	1759 E VINEYARD RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-5728
Country	:	US
Telephone Number	:	602-714-1391
Fax Number	:

Provider Business Practice Location Address
First Line	:	1759 E VINEYARD RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-5728
Country	:	US
Telephone Number	:	602-714-1391
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MRS. RACHEL HOBSON
Credential	:
Telephone Number	:	602-714-1391

Provider Enumeration Date	:	07/22/2010
Last Update Date	:	07/29/2010

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