Provider Demographics
NPI:1497381149
Name:ARIZONA HOME CARE SPECTRUM SOLUTIONS III LLC
Entity Type:Organization
Organization Name:ARIZONA HOME CARE SPECTRUM SOLUTIONS III LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTBROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-206-3999
Mailing Address - Street 1:3104 E CAMELBACK RD STE 1144
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4502
Mailing Address - Country:US
Mailing Address - Phone:480-206-3999
Mailing Address - Fax:
Practice Address - Street 1:1214 N PALM ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2375
Practice Address - Country:US
Practice Address - Phone:480-206-3999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility