Organization · NPI-2

Elk Bridge Homes, LLC

In Home Supportive Care · Peoria, AZ

NPI number1285288019
StatusActive
Last updated in NPPESJun 28, 2024

Details

NPI
1285288019
Entity type
Organization (NPI-2)
Legal business name
Elk Bridge Homes, LLC
Organization subpart
No
Enumeration date
Jul 30, 2019
Certification date
Jun 28, 2024
Last updated
Jun 28, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
253Z00000X In Home Supportive Care––Yes
261QD1600X Clinic/Center, Developmental Disabilities––

Practice location

13251 W Chaparosa Way
Peoria, AZ 85383-7845

Phone 602-448-2050

Mailing address

13251 W Chaparosa Way
Peoria, AZ 85383-7845

Phone 602-448-2050

Authorized official

Ryan Hoffmeyer
Ceo
6024482050

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