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Organization

LONGEVITY HOME CARE LLC DBA LONGEVITY HOME CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AARON VEGA (OWNER)
(623) 285-7218
Entity
Organization

Contact information

Practice address
8632 S 10TH LN, PHOENIX, AZ 85041-8337
(623) 285-7218
Mailing address
21834 N SUNSET DR, MARICOPA, AZ 85139-5483
(623) 285-7218

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
324500000X
Substance Abuse Rehabilitation Facility

Other

Enumeration date
04/21/2021
Last updated
04/21/2021
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