Provider Demographics
NPI:1114587722
Name:FOREVER SAFE HOME CARE, INC.
Entity Type:Organization
Organization Name:FOREVER SAFE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-688-2972
Mailing Address - Street 1:20325 N 51ST AVE STE 134
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5677
Mailing Address - Country:US
Mailing Address - Phone:623-688-2972
Mailing Address - Fax:
Practice Address - Street 1:20325 N 51ST AVE STE 134
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5677
Practice Address - Country:US
Practice Address - Phone:623-688-2972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care