Organization
JUANITA ANN WILLIAMS
Active
Other names
Sacred Living Home Care LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUANITA ANN WILLIAMS (CEO/PERSONAL CARE ATTENDANT)
(928) 856-9247
Entity
Organization
Contact information
Practice address
9 MILES WEST HWY 77 @ MP31, 9 MILES WEST HWY 77 @ MP31, INDIAN WELLS, AZ 86031
(928) 856-9247
Mailing address
PO BOX 3368, INDIAN WELLS, AZ 86031-3368
(928) 856-9247
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205836
AHCCCS INDEPENDENT PROVI
AZ
Enumeration date
10/10/2007
Last updated
11/27/2007
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