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AMANDA'S CARE HOME II LLC NPI 1275284234


NPI Information

NPI: 1275284234
Provider Name: AMANDA'S CARE HOME II LLC
Classification: Custodial Care Facility - 311Z00000X
Entity Type: Organization

CLIA Number: 03D1063588

Address:
8647 E PAMPA AVE
MESA, AZ
ZIP 85212
Phone: (480) 373-8437
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AMANDA'S CARE HOME II LLC is a custodial care facility in Mesa, AZ. The provider is a facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. AMANDA'S CARE HOME II LLC NPI is 1275284234. The provider is registered as an organization entity type.

The provider's business location address is:

8647 E PAMPA AVE
MESA, AZ
ZIP 85212-787
Phone: (480) 373-8437

The provider's authorized official is David Wanje .
The authorized official title is Owner and has the following contact phone number (909) 434-6940.

The CLIA number assigned to this NPI record is 03D1063588 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/12/2022 and was last updated on 1/13/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311ZA0620XCustodial Care FacilityAdult Care HomeNo
2311Z00000XCustodial Care FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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