Provider Demographics
NPI:1437527835
Name:ABODE HOME HEALTH ARIZONA, LLC
Entity Type:Organization
Organization Name:ABODE HOME HEALTH ARIZONA, LLC
Other - Org Name:PREMIER HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSLOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-576-0087
Mailing Address - Street 1:3550 N CENTRAL AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2111
Mailing Address - Country:US
Mailing Address - Phone:206-714-1410
Mailing Address - Fax:
Practice Address - Street 1:3550 N CENTRAL AVE STE 1220
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2105
Practice Address - Country:US
Practice Address - Phone:602-714-1410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-02
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health