Individual
TAKETHIA CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 E SOUTHERN AVE BLDG 2, PHOENIX, AZ 85040-5108
(602) 751-8647
Mailing address
1010 E SOUTHERN AVE BLDG 2, PHOENIX, AZ 85040-5108
(602) 751-8647
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
87-2680848
ACCESS FOR GROUP HOME CARE
AZ
Enumeration date
10/18/2021
Last updated
10/18/2021
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