Provider Demographics
NPI:1710157516
Name:CAREGIVER CONNECTION OF AZ, LLC
Entity Type:Organization
Organization Name:CAREGIVER CONNECTION OF AZ, LLC
Other - Org Name:ARISTOCARE HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMBOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-577-4825
Mailing Address - Street 1:698 E WETMORE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-1751
Mailing Address - Country:US
Mailing Address - Phone:520-577-4825
Mailing Address - Fax:520-529-0862
Practice Address - Street 1:698 E WETMORE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-1751
Practice Address - Country:US
Practice Address - Phone:520-577-4825
Practice Address - Fax:520-529-0862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHHA-3496251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ870932Medicaid