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Organization
BLACK MOUNTAIN BLESSING LLC
Active
Organization
BLACK MOUNTAIN BLESSING LLC
Active
Other names
Home Instead Senior Care
Organization subpart
No
Provider details
NPI number
Authorized official
AARON ROBERT STOUGH (OWNER/MEMBER)
(602) 362-3317
Entity
Organization
Contact information
Practice address
706 E BELL RD STE 120, PHOENIX, AZ 85022-6655
(602) 362-3317
(602) 344-9043
Mailing address
706 E BELL RD STE 120, PHOENIX, AZ 85022-6655
(602) 362-3317
(602) 344-9043
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
288318
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288318
—
AZ
Enumeration date
06/23/2018
Last updated
06/23/2018
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