Provider Demographics
NPI:1326865577
Name:IN HOME CARE AZ, LLC
Entity type:Organization
Organization Name:IN HOME CARE AZ, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPARKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-610-0635
Mailing Address - Street 1:9780 SW SHADY LN STE 101
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-5479
Mailing Address - Country:US
Mailing Address - Phone:503-610-0635
Mailing Address - Fax:
Practice Address - Street 1:11111 N SCOTTSDALE RD STE 205V
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6732
Practice Address - Country:US
Practice Address - Phone:503-610-0635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AFFORDABLE STAFFING 365, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care