Provider Demographics
NPI:1417186479
Name:ARIZONA CARE PROVIDERS LLC
Entity Type:Organization
Organization Name:ARIZONA CARE PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJABALLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-635-4220
Mailing Address - Street 1:2432 W PEORIA AVE STE 1048
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4729
Mailing Address - Country:US
Mailing Address - Phone:602-635-4220
Mailing Address - Fax:623-218-1216
Practice Address - Street 1:2432 W PEORIA AVE STE 1048
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4729
Practice Address - Country:US
Practice Address - Phone:602-635-4220
Practice Address - Fax:623-218-1216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-10
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251S00000XAgenciesCommunity/Behavioral Health
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child