03D1033362 CLIA NUMBER - HOME HEALTH AGENCY - ARIZONA, LLC DBA TEAM SELECT HOME CARE

Laboratory Demographics

CLIA Number: 03D1033362

Facility Name: HOME HEALTH AGENCY - ARIZONA, LLC DBA TEAM SELECT HOME CARE

Facility Address:
2999 N 44TH ST STE 100
PHOENIX, AZ
ZIP 85018
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Facility Phone Number: 480 618-5760

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1245224096

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name	Field Value
CLIA Number	03D1033362
LAB Type	Home Health Agency
Facility Name	HOME HEALTH AGENCY - ARIZONA, LLC DBA TEAM SELECT HOME CARE
Street	2999 N 44TH ST STE 100
City	PHOENIX
State	AZ
ZIP	85018
Phone	480 618-5760
CertificateType	4
CertificateEffectiveDate	11/8/2022
CertificateExpirationDate	11/7/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024