Provider Demographics
NPI:1740345735
Name:SC CARE SERVICES LLC
Entity type:Organization
Organization Name:SC CARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANCELLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-417-2000
Mailing Address - Street 1:3965 E. FOOTHILLS DRIVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-4252
Mailing Address - Country:US
Mailing Address - Phone:520-417-2000
Mailing Address - Fax:520-417-2012
Practice Address - Street 1:3965 E. FOOTHILLS DRIVE
Practice Address - Street 2:SUITE F
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-4252
Practice Address - Country:US
Practice Address - Phone:520-417-2000
Practice Address - Fax:520-417-2012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ948432Medicaid