Organization
FLAGSTONE HEALTHCARE IV
Active
Other names
Legacy Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
JACK COITO (PRESIDENT)
(818) 585-0564
Entity
Organization
Contact information
Practice address
2655 W GUADALUPE RD STE 18, MESA, AZ 85202-7246
(480) 777-0070
(480) 777-0072
Mailing address
2655 W GUADALUPE RD STE 18, MESA, AZ 85202-7246
(480) 777-0070
(480) 777-0072
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
04/10/2025
Last updated
04/10/2025
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