| Organization Name: | SEQUELCARE OF ARIZONA, LLC |
| NPI Number: | 1154443331 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NADINE RAMIREZ (DEPUTY DIRECTOR) |
| Mailing Address: | 8603 E. Eastridge Drive Ste. A Prescott Valley |
| State: | AZ US |
| Postal Code: | 86314 |
| Phone Number: | 9287773280 |
| Fax Number: | 9287781252 |
| NPI Enumeration Date: | 04/06/2007 |
| NPI Last Update Date: | 02/01/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | ========= A7 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |