Organization
A1 HOME HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MA GRACE CORAZON JUACHON FERNANDEZ (ADMINISTRATOR)
(602) 710-8782
Entity
Organization
Contact information
Practice address
4134 W CAMINO ACEQUIA, PHOENIX, AZ 85051-1040
(602) 710-8782
Mailing address
4134 W CAMINO ACEQUIA, PHOENIX, AZ 85051-1040
(602) 710-8782
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
11/13/2017
Last updated
11/13/2017
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