Provider Demographics
NPI:1497995526
Name:PHOENIX CARE SERVICE, LLC
Entity Type:Organization
Organization Name:PHOENIX CARE SERVICE, LLC
Other - Org Name:CARING SENIOR SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:F
Authorized Official - Last Name:DAUME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-944-0100
Mailing Address - Street 1:2301 W DUNLAP AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-2844
Mailing Address - Country:US
Mailing Address - Phone:602-944-0100
Mailing Address - Fax:602-997-2499
Practice Address - Street 1:2301 W DUNLAP AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-2844
Practice Address - Country:US
Practice Address - Phone:602-944-0100
Practice Address - Fax:602-997-2499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health