Provider Demographics
NPI:1841516556
Name:SELECT HOME CARE LLC
Entity type:Organization
Organization Name:SELECT HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING/ ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SELECT HOME
Authorized Official - Middle Name:CARE
Authorized Official - Last Name:LLC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-946-2233
Mailing Address - Street 1:65 S SYCAMORE STE 2
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-1143
Mailing Address - Country:US
Mailing Address - Phone:480-946-2233
Mailing Address - Fax:866-602-6851
Practice Address - Street 1:65 S SYCAMORE STE 2
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-1143
Practice Address - Country:US
Practice Address - Phone:480-946-2233
Practice Address - Fax:866-602-6851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-20
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251EOOOOOX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health