| Organization Name: | ELDERCARE FOR LIFE |
| NPI Number: | 1003082975 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MONICA VANDIVORT (PRESIDENT) |
| Mailing Address: | 6164 S Highway 92 Hereford |
| State: | AZ US |
| Postal Code: | 856159283 |
| Phone Number: | 5208031234 |
| Fax Number: | 5208036552 |
| NPI Enumeration Date: | 05/01/2008 |
| NPI Last Update Date: | 12/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |