Organization · NPI-2

4th Generation Home Care Service LLC

Home Health · Phoenix, AZ

NPI number1578317467
StatusActive
Last updated in NPPESApr 16, 2024

Details

NPI
1578317467
Entity type
Organization (NPI-2)
Legal business name
4th Generation Home Care Service LLC
Organization subpart
No
Enumeration date
Apr 16, 2024
Certification date
Apr 16, 2024
Last updated
Apr 16, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251E00000X Home Health––Yes

Practice location

2 N Central Ave # 1810
Phoenix, AZ 85004-2322

Phone 314-971-9784

Mailing address

2 N Central Ave # 1810
Phoenix, AZ 85004-2322

Phone 314-971-9784

Authorized official

Nacole M Taylor
Owner
3149719784

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