Provider Demographics
NPI:1295137362
Name:ARIZONA SELECT HOME HEALTH, INC.
Entity type:Organization
Organization Name:ARIZONA SELECT HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAYTH
Authorized Official - Middle Name:
Authorized Official - Last Name:JARULLAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-428-3526
Mailing Address - Street 1:7440 W CACTUS RD STE A19
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-9534
Mailing Address - Country:US
Mailing Address - Phone:480-428-3526
Mailing Address - Fax:480-428-3545
Practice Address - Street 1:7440 W CACTUS RD STE A19
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-9534
Practice Address - Country:US
Practice Address - Phone:480-428-3526
Practice Address - Fax:480-428-3545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-20
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHHA6895164W00000X, 224Z00000X, 225100000X, 225200000X, 225X00000X, 235Z00000X, 251F00000X, 251J00000X, 253Z00000X, 374U00000X, 385H00000X, 104100000X, 163WH0200X, 251E00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No251F00000XAgenciesHome InfusionGroup - Multi-Specialty
No251J00000XAgenciesNursing CareGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ153778OtherAHCCCS (STATE OF ARIZONA)
AZ153778OtherMERCY CARE PLAN (AHCCCS)
AZ153778Medicaid
AZ153778Medicaid