Provider Demographics
NPI:1790098481
Name:CARE EXCELLENCE HOME HEALTH AND SUPPORTIVE SERVICES
Entity Type:Organization
Organization Name:CARE EXCELLENCE HOME HEALTH AND SUPPORTIVE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-714-1391
Mailing Address - Street 1:1759 E VINEYARD RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-5728
Mailing Address - Country:US
Mailing Address - Phone:602-714-1391
Mailing Address - Fax:
Practice Address - Street 1:1759 E VINEYARD RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-5728
Practice Address - Country:US
Practice Address - Phone:602-714-1391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-22
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ529549Medicaid