Provider Demographics
NPI:1174559777
Name:HEALTH CARE@HOME, LLC
Entity type:Organization
Organization Name:HEALTH CARE@HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:COHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-443-0111
Mailing Address - Street 1:1204 E BASELINE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1453
Mailing Address - Country:US
Mailing Address - Phone:602-443-0111
Mailing Address - Fax:602-443-0110
Practice Address - Street 1:1204 E BASELINE RD STE 201
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1453
Practice Address - Country:US
Practice Address - Phone:602-443-0111
Practice Address - Fax:602-443-0110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHHA5892251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ618233Medicaid
AZ037435OtherMEDICARE PTAN
AZ618233Medicaid