Organization
ITC PERSONAL IN-HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSH GONZALES (OWNER)
(480) 969-5480
Entity
Organization
Contact information
Practice address
1345 E MAIN ST STE 110, MESA, AZ 85203-8950
(480) 969-5480
(480) 969-5512
Mailing address
1345 E MAIN ST STE 110, MESA, AZ 85203-8950
(480) 969-5480
(480) 969-5512
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
479687
AZ
Other
Enumeration date
08/20/2012
Last updated
08/20/2012
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