Provider Demographics
NPI:1164911830
Name:HODGES HANEI CORPORATION
Entity Type:Organization
Organization Name:HODGES HANEI CORPORATION
Other - Org Name:FIRSTLIGHT HOME CARE OF SUN CITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRON
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-396-3205
Mailing Address - Street 1:9610 W PINNACLE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-8711
Mailing Address - Country:US
Mailing Address - Phone:404-396-3205
Mailing Address - Fax:
Practice Address - Street 1:14050 N 83RD AVE STE 290
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-5650
Practice Address - Country:US
Practice Address - Phone:623-201-7716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care