# LOS NINOS INNOVATIVE HOME HEALTHCARE

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

## Provider details

- **NPI number:** 1992057525
- **Authorized official:** PAULINE J ZAUTKE (PROGRAM ADMINISTRATOR)
- **Authorized official phone:** (602) 305-9500

## Contact information

- **Practice address:** 2601 E THOMAS RD, SUITE 230, PHOENIX, AZ 85016-8221
- **Practice address phone:** (602) 305-9500
- **Practice address fax:** (602) 305-9501
- **Mailing address:** 1402 E SOUTH MOUNTAIN AVE, PHOENIX, AZ 85042-7925
- **Mailing address phone:** (602) 243-4231

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | LP034892 | AZ | Yes |

## Other

- **Enumeration date:** 10/05/2012
- **Last updated:** 02/13/2025