Provider Demographics
NPI:1275774846
Name:HOME CARE ASSOCIATES, INC.
Entity Type:Organization
Organization Name:HOME CARE ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACKELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-545-6255
Mailing Address - Street 1:1111 N GILBERT RD
Mailing Address - Street 2:SUITE 210A
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2313
Mailing Address - Country:US
Mailing Address - Phone:480-545-6255
Mailing Address - Fax:480-545-6257
Practice Address - Street 1:1111 N GILBERT RD
Practice Address - Street 2:SUITE 210A
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2313
Practice Address - Country:US
Practice Address - Phone:480-545-6255
Practice Address - Fax:480-545-6257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-11
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ037289OtherMEDICARE PTAN
AZ625186Medicaid