Provider Demographics
NPI:1447449384
Name:ASSISTED CARE INC
Entity type:Organization
Organization Name:ASSISTED CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:
Authorized Official - Last Name:MC DONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-493-4986
Mailing Address - Street 1:PO BOX 1013
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92556-1013
Mailing Address - Country:US
Mailing Address - Phone:602-493-4986
Mailing Address - Fax:480-445-9790
Practice Address - Street 1:2737 E GREENWAY RD
Practice Address - Street 2:3
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4391
Practice Address - Country:US
Practice Address - Phone:602-493-4986
Practice Address - Fax:480-445-9790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies