Provider Demographics
NPI:1073855417
Name:ARISTOCARE MANAGEMENT, LLC
Entity Type:Organization
Organization Name:ARISTOCARE MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTIAAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:520-490-4222
Mailing Address - Street 1:1650 W KITTY HAWK WAY
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85755-8890
Mailing Address - Country:US
Mailing Address - Phone:520-490-4222
Mailing Address - Fax:
Practice Address - Street 1:4525 E SKYLINE DR STE 129
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-1601
Practice Address - Country:US
Practice Address - Phone:520-490-4222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-25
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health