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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTI TADDONIO MBA (DIRECTOR HR & FINANCE)
(480) 221-8653
Entity
Organization

Contact information

Practice address
2722 N WEST ST, FLAGSTAFF, AZ 86004-3424
(233) 269-6406
Mailing address
2722 N WEST ST, FLAGSTAFF, AZ 86004-3424
(480) 221-8653

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary

Other

Enumeration date
03/14/2022
Last updated
03/14/2022
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