Provider Demographics
NPI:1962914523
Name:EPIC CARE TEAM INC
Entity type:Organization
Organization Name:EPIC CARE TEAM INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DIIGBO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-522-7847
Mailing Address - Street 1:3800 N ELMIRAGE ROAD, UNIT 3424
Mailing Address - Street 2:3800 N ELMIRAGE ROAD, UNIT 3424
Mailing Address - City:AVONDALE, ARIZONA USA,
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-3998
Mailing Address - Country:US
Mailing Address - Phone:480-480-5227
Mailing Address - Fax:
Practice Address - Street 1:3800 N ELMIRAGE ROAD, UNIT 3424
Practice Address - Street 2:3800 N ELMIRAGE ROAD, UNIT 3424
Practice Address - City:AVONDALE, ARIZONA USA,
Practice Address - State:AZ
Practice Address - Zip Code:85392-3998
Practice Address - Country:US
Practice Address - Phone:480-480-5227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-03
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ09324251E00000X, 253Z00000X, 3747A0650X, 374U00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty