Provider Demographics
NPI:1598401127
Name:ARIZONA CARES
Entity Type:Organization
Organization Name:ARIZONA CARES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOENATHAN
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-456-4442
Mailing Address - Street 1:1616 N LITCHFIELD RD STE 240
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-1288
Mailing Address - Country:US
Mailing Address - Phone:623-244-1649
Mailing Address - Fax:
Practice Address - Street 1:1616 N LITCHFIELD RD STE 240
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-1288
Practice Address - Country:US
Practice Address - Phone:623-244-1649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ003527Medicaid