Organization
CONVINI CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEREFORD JOHNSON (CEO)
(623) 321-2542
Entity
Organization
Contact information
Practice address
4539 N 22ND ST STE R, PHOENIX, AZ 85016-4639
(623) 321-2542
Mailing address
14256 W CALLE LEJOS, SURPRISE, AZ 85387-1838
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
11/06/2025
Last updated
11/24/2025
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