Provider Demographics
NPI:1578304291
Name:THE VALLEY FAMILY CARE LLC
Entity type:Organization
Organization Name:THE VALLEY FAMILY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAHR
Authorized Official - Middle Name:J
Authorized Official - Last Name:KAI
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:602-405-3655
Mailing Address - Street 1:5648 W SOUTHGATE AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85043-6310
Mailing Address - Country:US
Mailing Address - Phone:602-405-3655
Mailing Address - Fax:
Practice Address - Street 1:1717 W NORTHERN AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-5469
Practice Address - Country:US
Practice Address - Phone:623-703-2655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities