Provider Demographics
NPI:1285455394
Name:NEW HEIGHTS QC HEALTH SERVICES LLC
Entity type:Organization
Organization Name:NEW HEIGHTS QC HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SERGE
Authorized Official - Middle Name:
Authorized Official - Last Name:TABARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-828-0578
Mailing Address - Street 1:3593 W GOLDMINE MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85144-6592
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3593 W GOLDMINE MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85144-6592
Practice Address - Country:US
Practice Address - Phone:480-828-0578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care