Provider Demographics
NPI:1851947865
Name:AZ CARE PARTNERS HOME CARE, LLC
Entity Type:Organization
Organization Name:AZ CARE PARTNERS HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BONGOYAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:623-203-6678
Mailing Address - Street 1:14122 W. MCDOWELL RD., SUITE 102A
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395
Mailing Address - Country:US
Mailing Address - Phone:623-512-1266
Mailing Address - Fax:888-788-1251
Practice Address - Street 1:14122 W. MCDOWELL RD., SUITE 102A
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395
Practice Address - Country:US
Practice Address - Phone:623-512-1266
Practice Address - Fax:888-788-1251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty