Provider Demographics
NPI:1083469423
Name:ELECTUS HOME CARE
Entity Type:Organization
Organization Name:ELECTUS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-502-4275
Mailing Address - Street 1:4909 N WOODMERE FAIRWAY UNIT 3007
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-1767
Mailing Address - Country:US
Mailing Address - Phone:503-502-4275
Mailing Address - Fax:
Practice Address - Street 1:4909 N WOODMERE FAIRWAY UNIT 3007
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-1767
Practice Address - Country:US
Practice Address - Phone:503-502-4275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care