Provider Demographics
NPI:1437924321
Name:INFINITY LIFE HOME CARE
Entity Type:Organization
Organization Name:INFINITY LIFE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAYLA
Authorized Official - Middle Name:SHY'ANN
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-817-8063
Mailing Address - Street 1:1600 W LA JOLLA DR APT 2034
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-4460
Mailing Address - Country:US
Mailing Address - Phone:602-817-8063
Mailing Address - Fax:
Practice Address - Street 1:1600 W LA JOLLA DR APT 2034
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-4460
Practice Address - Country:US
Practice Address - Phone:148-022-8163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care