Provider Demographics
NPI:1134868995
Name:NEXTCARE PROVIDERS LLC
Entity type:Organization
Organization Name:NEXTCARE PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLY
Authorized Official - Middle Name:
Authorized Official - Last Name:NGANGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-743-1205
Mailing Address - Street 1:2942 N 24TH ST STE 114-349
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7878
Mailing Address - Country:US
Mailing Address - Phone:480-743-1205
Mailing Address - Fax:480-666-6765
Practice Address - Street 1:2942 N 24TH ST STE 114-349
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7878
Practice Address - Country:US
Practice Address - Phone:480-743-1205
Practice Address - Fax:480-666-6765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health