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Organization

PRIVATE SUITE HOME CARE AGENCY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. NADINE LOLLIE REGISTERED NURSE (CEO/FOUNDER)
(248) 894-4039
Entity
Organization

Contact information

Practice address
15263 S 14TH PL, PHOENIX, AZ 85048-6260
(248) 894-4039
Mailing address
15263 S 14TH PL, PHOENIX, AZ 85048-6260

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
AZ
385H00000X
Respite Care

Other

Enumeration date
09/12/2017
Last updated
09/12/2017
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