Provider Demographics
NPI:1114316585
Name:AL KHAROUF ENTERPRISES
Entity Type:Organization
Organization Name:AL KHAROUF ENTERPRISES
Other - Org Name:CARING HEARTS OF ARIZONA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:AL KHAROUF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-499-8090
Mailing Address - Street 1:8080 S. FAIRFIELD CIRCLE
Mailing Address - Street 2:
Mailing Address - City:HEREFORD
Mailing Address - State:AZ
Mailing Address - Zip Code:85615
Mailing Address - Country:US
Mailing Address - Phone:520-499-8090
Mailing Address - Fax:
Practice Address - Street 1:8081 S FAIRFIELD CIR
Practice Address - Street 2:
Practice Address - City:HEREFORD
Practice Address - State:AZ
Practice Address - Zip Code:85615-8546
Practice Address - Country:US
Practice Address - Phone:520-499-8090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ968974Medicaid