MEDICARE: PREFERRED CARE SOLUTIONS 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1821626284
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED CARE SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	11418 W ROSEWOOD DR
Second Line	:
City	:	AVONDALE
State	:	AZ
Zip	:	85392-3421
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2651 N 50TH AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85035-2005
Country	:	US
Telephone Number	:	602-430-9646
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DR. LAMECK NYAKWEBA
Credential	:
Telephone Number	:	602-430-9646

Provider Enumeration Date	:	03/31/2020
Last Update Date	:	03/31/2020

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Directions to “PREFERRED CARE SOLUTIONS LLC ” Practice Location

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