Provider Demographics
NPI:1568639557
Name:AZHOMEHEALTH LLC
Entity Type:Organization
Organization Name:AZHOMEHEALTH LLC
Other - Org Name:ASSISTEO HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:HILLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-535-0610
Mailing Address - Street 1:2929 N 44TH ST
Mailing Address - Street 2:STE 130
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-7238
Mailing Address - Country:US
Mailing Address - Phone:602-535-0610
Mailing Address - Fax:602-293-3717
Practice Address - Street 1:2929 N 44TH ST
Practice Address - Street 2:STE 130
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-7238
Practice Address - Country:US
Practice Address - Phone:602-535-0610
Practice Address - Fax:602-293-3717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHHA43A6251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ425922Medicaid
AZ425922Medicaid