Provider Demographics
NPI:1013682616
Name:INSPIRED HOMECARE OF ARIZONA, LLC
Entity Type:Organization
Organization Name:INSPIRED HOMECARE OF ARIZONA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-366-8936
Mailing Address - Street 1:2421 E SOUTHERN AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7612
Mailing Address - Country:US
Mailing Address - Phone:708-854-7428
Mailing Address - Fax:
Practice Address - Street 1:2421 E SOUTHERN AVE STE 8
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7612
Practice Address - Country:US
Practice Address - Phone:706-854-7428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health