Organization
AMANI HOME HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIUD WANGUSI (OWNER/MANAGER)
(480) 584-4435
Entity
Organization
Contact information
Practice address
1639 N FRASER DR, MESA, AZ 85203-2665
(480) 584-4435
(480) 584-4072
Mailing address
1639 N FRASER DR, MESA, AZ 85203-2665
(480) 584-4435
(480) 584-4072
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL7506H
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
477031
AHCCCS IDENTIFICATION NUMBER
AZ
Enumeration date
07/05/2011
Last updated
07/05/2011
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