Provider Demographics
NPI:1356680938
Name:JIRALOGIC, LLC DBA FIRSTLIGHT HOMECARE OF SCOTTSDALE
Entity Type:Organization
Organization Name:JIRALOGIC, LLC DBA FIRSTLIGHT HOMECARE OF SCOTTSDALE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:R
Authorized Official - Last Name:CREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-922-2820
Mailing Address - Street 1:7585 E REDFIELD RD
Mailing Address - Street 2:#105
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6936
Mailing Address - Country:US
Mailing Address - Phone:480-922-2820
Mailing Address - Fax:480-452-0403
Practice Address - Street 1:7585 E REDFIELD RD
Practice Address - Street 2:#105
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6936
Practice Address - Country:US
Practice Address - Phone:480-922-2820
Practice Address - Fax:480-452-0403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-02
Last Update Date:2013-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1077172251E00000X
311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility