Organization
FSL PROGRAMS
Active
Other names
Home Health - Maricopa County
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNETTE INIGUEZ (EXECUTIVE ASSISTANT)
(602) 285-0505
Entity
Organization
Contact information
Practice address
1201 E THOMAS RD, PHOENIX, AZ 85014-5734
(602) 285-1800
(602) 285-1838
Mailing address
1201 E THOMAS RD, PHOENIX, AZ 85014-5734
(602) 285-1800
(602) 285-1838
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HHA0110
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
652223
—
AZ
01
—
HHA0110
ADHS LICENSE
AZ
Enumeration date
12/27/2006
Last updated
10/03/2007
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