Provider Demographics
NPI:1043906126
Name:SORAIYA HOME CARE LLC
Entity Type:Organization
Organization Name:SORAIYA HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SA
Authorized Official - Middle Name:
Authorized Official - Last Name:ME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:385-237-9712
Mailing Address - Street 1:1287 N SIR PHILIP DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84116-4410
Mailing Address - Country:US
Mailing Address - Phone:385-237-9712
Mailing Address - Fax:260-387-7808
Practice Address - Street 1:1287 N SIR PHILIP DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84116-4410
Practice Address - Country:US
Practice Address - Phone:385-237-9712
Practice Address - Fax:260-387-7808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care