1902044258 NPI number — ASSURANCE HOME CARE, INC.

Table of content: (NPI 1902044258)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902044258 NPI number — ASSURANCE HOME CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSURANCE HOME CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ARISTA HOME HEALTH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902044258
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/13/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1636 N SWAN RD STE 250
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85712-4067
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-333-0333
Provider Business Mailing Address Fax Number:
520-325-9938

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1636 N SWAN RD STE 250
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85712-4067
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-333-0333
Provider Business Practice Location Address Fax Number:
520-325-9938
Provider Enumeration Date:
01/24/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SIPE
Authorized Official First Name:
DANIELLE
Authorized Official Middle Name:
I
Authorized Official Title or Position:
MEMBER/OWNER
Authorized Official Telephone Number:
520-333-0333

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HHA4602 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: HHA8430 . This is a "STATE LICENSE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 664775 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".