Provider Demographics
NPI:1720805807
Name:TRU BLUE HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:TRU BLUE HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRU BLUE HOME HEALTH
Authorized Official - Middle Name:
Authorized Official - Last Name:LLC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-347-9482
Mailing Address - Street 1:16027 N 19TH DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-7280
Mailing Address - Country:US
Mailing Address - Phone:480-347-9482
Mailing Address - Fax:
Practice Address - Street 1:16027 N 19TH DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-7280
Practice Address - Country:US
Practice Address - Phone:480-347-9482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health