Provider Demographics
NPI:1609073956
Name:WHC SENIOR SERVICES GROUP
Entity Type:Organization
Organization Name:WHC SENIOR SERVICES GROUP
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-265-8228
Mailing Address - Street 1:5350 N 16TH ST
Mailing Address - Street 2:SUITE #100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-3213
Mailing Address - Country:US
Mailing Address - Phone:602-265-8228
Mailing Address - Fax:
Practice Address - Street 1:5350 N 16TH ST
Practice Address - Street 2:SUITE #100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-3213
Practice Address - Country:US
Practice Address - Phone:602-265-8228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ105512Medicare ID - Type Unspecified105512