Provider Demographics
NPI:1215291349
Name:AVANZAR HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:AVANZAR HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:EVANGELISTA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:480-840-5818
Mailing Address - Street 1:2031 E. INDIGO DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286
Mailing Address - Country:US
Mailing Address - Phone:480-359-9501
Mailing Address - Fax:888-311-8883
Practice Address - Street 1:455 N. MESA DRIVE
Practice Address - Street 2:STE. 9
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201
Practice Address - Country:US
Practice Address - Phone:480-359-9501
Practice Address - Fax:888-311-8883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-04
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health