Provider Demographics
NPI:1275797169
Name:PHOENIX VALLEY SENIOR CARE
Entity Type:Organization
Organization Name:PHOENIX VALLEY SENIOR CARE
Other - Org Name:RIGHT AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:480-632-1100
Mailing Address - Street 1:1450 W GUADALUPE RD
Mailing Address - Street 2:STE 115
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-3042
Mailing Address - Country:US
Mailing Address - Phone:480-632-1100
Mailing Address - Fax:480-632-0230
Practice Address - Street 1:1450 W GUADALUPE RD
Practice Address - Street 2:STE 115
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-3042
Practice Address - Country:US
Practice Address - Phone:480-632-1100
Practice Address - Fax:480-632-0230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty