- Enrollment id
- O20070629000620
- Enrollment state
- AZ
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1083836183
- Multiple npi flag
- N
- Ccn
- 037257
- Associate id
- 5092814137
- Organization name
- CELEBRITY HOMEHEALTH INC.
- Doing business as name
- CELEBRITY HOMEHEALTH & HOSPICE
- Incorporation date
- 2005-04-29
- Incorporation state
- AZ
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 2510 S RURAL RD
- Address line 2
- STE 102
- City
- TEMPE
- State
- AZ
- Zip code
- 852822497