Organization
GWEN'S ADVANCE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE JOLINE LOPEZ RN, BSN (CARE COORDINATOR)
(602) 595-5707
Entity
Organization
Contact information
Practice address
1635 E BASELINE RD STE 109, PHOENIX, AZ 85042-6891
(602) 595-5707
(602) 595-7147
Mailing address
1635 E BASELINE RD STE 109, PHOENIX, AZ 85042-6891
(602) 595-5707
(602) 595-7147
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
12/05/2018
Last updated
01/15/2020
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