# 2ND HOME SKILLED CARE SERVICES ARIZONA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346060456
- **Authorized official:** HANEEN M OMAR (CEO)
- **Authorized official phone:** (303) 999-7763

## Contact information

- **Practice address:** 2325 E CAMELBACK RD STE 476, PHOENIX, AZ 85016-3422
- **Practice address phone:** (303) 999-7763
- **Mailing address:** 3131 S VAUGHN WAY STE 600, AURORA, CO 80014-3508
- **Mailing address phone:** (303) 999-7763

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/14/2024
- **Last updated:** 10/14/2024