# HYDE PARK HOME HEALTHCARE

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

## Provider details

- **NPI number:** 1780084301
- **Authorized official:** JAN SHAFER (ADMINISTRATOR)
- **Authorized official phone:** (623) 330-2838

## Contact information

- **Practice address:** 14850 N SCOTTSDALE RD, \#450-B, SCOTTSDALE, AZ 85254-2798
- **Practice address phone:** (480) 250-0304
- **Practice address fax:** (480) 237-8770
- **Mailing address:** 14850 N SCOTTSDALE RD, \#450-B, SCOTTSDALE, AZ 85254-2798
- **Mailing address phone:** (480) 250-0304
- **Mailing address fax:** (480) 237-8770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | HHA5794 | AZ | Yes |

## Other

- **Enumeration date:** 09/02/2014
- **Last updated:** 09/02/2014