Provider Demographics
NPI:1962091983
Name:AZ COMFORT HOME CARE , LLC
Entity type:Organization
Organization Name:AZ COMFORT HOME CARE , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KLODIA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUKHANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-698-8337
Mailing Address - Street 1:6390 W BELL RD STE A1
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3614
Mailing Address - Country:US
Mailing Address - Phone:623-698-8337
Mailing Address - Fax:623-248-7842
Practice Address - Street 1:6390 W BELL RD STE A1
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3614
Practice Address - Country:US
Practice Address - Phone:623-698-8337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care