Organization
TRADITIONAL HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LULA M NEZ (OWNER)
(928) 871-5021
Entity
Organization
Contact information
Practice address
1/4 MILE N. TWO STORY RD., RA #31, ST. MICHAELS, AZ 86511
(928) 871-5021
(928) 810-3998
Mailing address
PO BOX 998, ST MICHAELS, AZ 86511-0998
(928) 871-5021
(928) 810-3998
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
415780
AZ
Other
Enumeration date
07/26/2012
Last updated
07/26/2012
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