Organization
ADVANCE CARE & HOME SUPPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERDINAND CAPO-CHICHI (CEO)
(832) 709-7530
Entity
Organization
Contact information
Practice address
4638 N 111TH LN, PHOENIX, AZ 85037-8333
(480) 395-0233
Mailing address
4638 N 111TH LN, PHOENIX, AZ 85037-8333
(480) 395-0233
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/03/2023
Last updated
02/03/2023
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