Organization
@ HEART HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PEARLINE CHIA (OWNER)
(505) 406-4269
Entity
Organization
Contact information
Practice address
HIGHWAY 264 LOS VERDES TRAILER COURTS, SAINT MICHAELS, AZ 86511
(505) 406-4269
Mailing address
PO BOX 4613, WINDOW ROCK, AZ 86515-4613
(505) 406-4269
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
438330
AHCCCS/MEDICAID ID NUMBER
AZ
Enumeration date
07/16/2009
Last updated
07/16/2009
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