Provider Demographics
NPI:1609515634
Name:A1 HOME CARE LLC
Entity Type:Organization
Organization Name:A1 HOME CARE LLC
Other - Org Name:A1 HOME CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARMELITA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-451-2711
Mailing Address - Street 1:1155 S POWER RD # 114-122
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-3715
Mailing Address - Country:US
Mailing Address - Phone:602-451-2711
Mailing Address - Fax:
Practice Address - Street 1:1155 S POWER RD # 114-122
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-3715
Practice Address - Country:US
Practice Address - Phone:602-451-2711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-28
Last Update Date:2023-08-15
Deactivation Date:2022-11-18
Deactivation Code:
Reactivation Date:2023-07-10
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health