Provider Demographics
NPI:1780268623
Name:VALLEY CARE LLC
Entity type:Organization
Organization Name:VALLEY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:G
Authorized Official - Last Name:MATOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-766-1999
Mailing Address - Street 1:3142 W MARSHALL AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85017-2420
Mailing Address - Country:US
Mailing Address - Phone:773-766-1999
Mailing Address - Fax:
Practice Address - Street 1:3142 W MARSHALL AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85017-2420
Practice Address - Country:US
Practice Address - Phone:773-766-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care