| Organization Name: | BANNER HOME CARE ARIZONA |
| NPI Number: | 1073550547 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DENNIS E DAHLEN (SR. VICE PRESIDENT) |
| Mailing Address: | 7231 E Broadway Rd Mesa |
| State: | AZ US |
| Postal Code: | 852082009 |
| Phone Number: | 4804978250 |
| Fax Number: | |
| NPI Enumeration Date: | 06/01/2006 |
| NPI Last Update Date: | 09/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |