Organization
ITC PERSONAL IN-HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN THOMAS FORSGREN (DIRECTOR)
(480) 969-5480
Entity
Organization
Contact information
Practice address
759 N LINDSAY RD, MESA, AZ 85213-6816
(480) 969-5480
(480) 969-5512
Mailing address
759 N LINDSAY RD, MESA, AZ 85213-6816
(480) 969-5480
(480) 969-5512
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
479687
AZ
Other
Enumeration date
11/13/2014
Last updated
11/13/2014
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