Provider Demographics
NPI:1831864677
Name:VANWARD CARE LLC
Entity type:Organization
Organization Name:VANWARD CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:EARHART
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:815-520-3658
Mailing Address - Street 1:15345 W ROMA AVE
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-6354
Mailing Address - Country:US
Mailing Address - Phone:815-520-3658
Mailing Address - Fax:
Practice Address - Street 1:4114 E LIBERTY LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-0530
Practice Address - Country:US
Practice Address - Phone:815-520-3658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility