Provider Demographics
NPI:1043984321
Name:DENPTAAJ LLC
Entity Type:Organization
Organization Name:DENPTAAJ LLC
Other - Org Name:DENPTA HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:
Authorized Official - Last Name:OTITEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-625-1447
Mailing Address - Street 1:38035 53RD ST E
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93552-3224
Mailing Address - Country:US
Mailing Address - Phone:424-625-1447
Mailing Address - Fax:
Practice Address - Street 1:2531 OLIVE DR STE E
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-1036
Practice Address - Country:US
Practice Address - Phone:424-625-1447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-02
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care