Provider Demographics
NPI:1073153425
Name:DEL RIO IN-HOME LLC
Entity Type:Organization
Organization Name:DEL RIO IN-HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:KIBET
Authorized Official - Last Name:ROTICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-339-3327
Mailing Address - Street 1:8136 W PIMA ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85043-5448
Mailing Address - Country:US
Mailing Address - Phone:520-339-3327
Mailing Address - Fax:
Practice Address - Street 1:8136 W PIMA ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85043-5448
Practice Address - Country:US
Practice Address - Phone:520-339-3327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health