Provider Demographics
NPI:1497162804
Name:AMERICAN CARE HOMES, INC.
Entity Type:Organization
Organization Name:AMERICAN CARE HOMES, INC.
Other - Org Name:DBA AHWATUKEE ADULT CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:GARCIA
Authorized Official - Last Name:DATINGALING
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:602-277-8721
Mailing Address - Street 1:3418 E INDIAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-5113
Mailing Address - Country:US
Mailing Address - Phone:602-277-8721
Mailing Address - Fax:602-224-1357
Practice Address - Street 1:3418 E INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-5113
Practice Address - Country:US
Practice Address - Phone:602-277-8721
Practice Address - Fax:602-224-1357
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN CARE HOMES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
STILL WAITING101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZNPI 1811133275OtherNPI # 1811133275 FOR ADDRESS 5135 E. HALF MOON DRIVE PHOENIX AZ 85044