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Organization

HOUSE OF SHELTER INCORPORATED

Active
Parent organization
HOUSE OF SHELTER INCORPORATED
Organization subpart
Yes

Provider details

NPI number
Legal business name
HOUSE OF SHELTER INCORPORATED
Authorized official
FLOYD H JONES MPA (CEO/PROVIDER)
(623) 221-1579
Entity
Organization

Contact information

Practice address
15757 W MORELAND ST, GOODYEAR, AZ 85338-4161
(623) 221-1579
Mailing address
15757 W MORELAND ST, GOODYEAR, AZ 85338-4161
(623) 221-1579

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
LCR-213259-4481
AZ
Enumeration date
09/03/2020
Last updated
09/03/2020
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