Provider Demographics
NPI:1417839069
Name:AGE OF WISDOM SENIOR CARE SERVICES, LLC
Entity type:Organization
Organization Name:AGE OF WISDOM SENIOR CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:469-765-7751
Mailing Address - Street 1:15411 W WADDELL RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-5170
Mailing Address - Country:US
Mailing Address - Phone:325-433-8485
Mailing Address - Fax:325-274-8767
Practice Address - Street 1:15411 W WADDELL RD STE 102
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-5170
Practice Address - Country:US
Practice Address - Phone:325-433-8485
Practice Address - Fax:325-274-8767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care