Organization
VCG ARIZONA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS WALKER (CHIEF OPERATING OFFICER)
(214) 491-0041
Entity
Organization
Contact information
Practice address
1280 S 20TH AVE STE A2, SAFFORD, AZ 85546-3378
(903) 787-7609
Mailing address
8150 N CENTRAL EXPY STE 1800, DALLAS, TX 75206-1883
(903) 787-7609
(903) 871-0005
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HHA10774
STATE OF ARIZONA LICENSE
AZ
Enumeration date
07/17/2023
Last updated
07/18/2023
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