Provider Demographics
NPI:1407100118
Name:CURA HOME CARE SERVICES, LLC
Entity Type:Organization
Organization Name:CURA HOME CARE SERVICES, LLC
Other - Org Name:HOMEWATCH CAREGIVERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:FERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-953-2872
Mailing Address - Street 1:PO BOX 54727
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85078-4727
Mailing Address - Country:US
Mailing Address - Phone:602-953-2872
Mailing Address - Fax:602-953-2875
Practice Address - Street 1:11201 N TATUM BLVD
Practice Address - Street 2:SUITE 315
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-6036
Practice Address - Country:US
Practice Address - Phone:602-953-2872
Practice Address - Fax:602-953-2875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ292858Medicaid