Provider Demographics
NPI:1225585979
Name:ASSISTED HOME CARE, INC.
Entity Type:Organization
Organization Name:ASSISTED HOME CARE, INC.
Other - Org Name:ASSISTED HOME HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-371-9988
Mailing Address - Street 1:72 MOODY CT
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-6067
Mailing Address - Country:US
Mailing Address - Phone:805-371-9988
Mailing Address - Fax:805-371-9987
Practice Address - Street 1:1420 E MISSOURI AVE STE 103
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2405
Practice Address - Country:US
Practice Address - Phone:480-860-8021
Practice Address - Fax:480-860-8022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-09
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ031658Medicare Oscar/Certification