Organization
HERITAGE HOME HEALTHCARE OF ARIZONA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY JOHANSEN (PRESIDENT)
(605) 362-3320
Entity
Organization
Contact information
Practice address
7310 N. 16TH ST, SUITE 228, PHOENIX, AZ 85020
(602) 745-2900
(602) 745-2909
Mailing address
7310 N. 16TH ST., SUITE 228, PHOENIX, AZ 85020
(602) 745-2900
(602) 745-2909
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
HHA4166
AZ
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132889
—
AZ
05
—
135248
—
AZ
Enumeration date
05/19/2006
Last updated
03/22/2017
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