Provider Demographics
NPI:1326400847
Name:MINDFUL HOME HEALTH PLLC
Entity Type:Organization
Organization Name:MINDFUL HOME HEALTH PLLC
Other - Org Name:MINDFUL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANGILERI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:602-799-5958
Mailing Address - Street 1:2487 S GILBERT RD
Mailing Address - Street 2:106-129
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-8899
Mailing Address - Country:US
Mailing Address - Phone:480-788-3793
Mailing Address - Fax:
Practice Address - Street 1:2487 S GILBERT RD
Practice Address - Street 2:106-129
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-8899
Practice Address - Country:US
Practice Address - Phone:480-788-3793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-23
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN151551163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZRN151551OtherSTATE LICENSE