Provider Demographics
NPI:1083398440
Name:EAST VALLEY SENIORS LLC
Entity Type:Organization
Organization Name:EAST VALLEY SENIORS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:EMMELHAINZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-534-7413
Mailing Address - Street 1:36073 N STONEWARE DR
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-7230
Mailing Address - Country:US
Mailing Address - Phone:480-534-7413
Mailing Address - Fax:480-912-1229
Practice Address - Street 1:36073 N STONEWARE DR
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85140-7230
Practice Address - Country:US
Practice Address - Phone:480-534-7413
Practice Address - Fax:480-912-1229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care