Organization · NPI-2

Cherished Moments Home Care Services LLC

In Home Supportive Care · Glendale, AZ

NPI number1619696747

StatusActive

Last updated in NPPESAug 23, 2022

Details

NPI: 1619696747
Entity type: Organization (NPI-2)
Legal business name: Cherished Moments Home Care Services LLC
Organization subpart: No
Enumeration date: Aug 23, 2022
Certification date: Aug 23, 2022
Last updated: Aug 23, 2022

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
253Z00000X	In Home Supportive Care	–	–	Yes
251C00000X	Day Training, Developmentally Disabled Services	–	–
332U00000X	Home Delivered Meals	–	–
347C00000X	Private Vehicle	–	–
385H00000X	Respite Care	–	–
385HR2055X	Respite Care, Respite Care, Mental Illness, Child	–	–
385HR2060X	Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child	–	–
385HR2065X	Respite Care, Respite Care, Physical Disabilities, Child	–	–

Practice location

13621 W Glendale Ave
Unit 1126
Glendale, AZ 85307

Phone 559-213-0468

Mailing address

4350 W Camelback Rd # 1038
Glendale, AZ 85301-7606

Phone 559-213-0468

Authorized official

D'Amitra S Marshall
Owner
5592130468

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