Provider Demographics
NPI:1235675737
Name:APOLLO HEALTH CARE, INC.
Entity Type:Organization
Organization Name:APOLLO HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:N
Authorized Official - Last Name:JORGE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:602-909-9026
Mailing Address - Street 1:2209 N RASCON LOOP
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-4357
Mailing Address - Country:US
Mailing Address - Phone:602-909-9026
Mailing Address - Fax:
Practice Address - Street 1:2209 N RASCON LOOP
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-4357
Practice Address - Country:US
Practice Address - Phone:602-909-9026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH50223104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZBH5022OtherARIZONA DEPARTMENT OF HEALTH SERVICES