SRC1 II LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

037185 Issued in AZ

Legal business name

SRC1 II LLC

Practice address

6240 E Thomas Rd
Suite 203
Scottsdale, AZ 85251-7017

Phone

(480) 946-4145

Fax

(480) 946-1280

NPI assigned

Nov 13, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Patricia Ann Kuzia, RN

Title

Executive Director

Phone

(480) 946-4145

Specialties & licenses 1

Addresses

Other names 1

• SafeNet Home Health Services Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1013088780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6240 E THOMAS RD",
            "address_2": "SUITE 203",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517017",
            "telephone_number": "480-946-4145",
            "fax_number": "480-946-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6240 E THOMAS RD",
            "address_2": "SUITE 203",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517017",
            "telephone_number": "480-946-4145",
            "fax_number": "480-946-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRC1 II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "KUZIA",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "480-946-4145",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AZ",
            "license": "037185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SafeNet Home Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Home Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.