Provider Demographics
NPI:1497003537
Name:AVOCARE HOME HEALTH PLUS, INC
Entity Type:Organization
Organization Name:AVOCARE HOME HEALTH PLUS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:VICTUELLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-932-3552
Mailing Address - Street 1:250 N LITCHFIELD RD
Mailing Address - Street 2:STE 200
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-1333
Mailing Address - Country:US
Mailing Address - Phone:623-932-3552
Mailing Address - Fax:623-882-3273
Practice Address - Street 1:250 N LITCHFIELD RD
Practice Address - Street 2:STE 200
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-1333
Practice Address - Country:US
Practice Address - Phone:623-932-3552
Practice Address - Fax:623-882-3273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-21
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ03-7431Medicare PIN