Provider Demographics
NPI:1538507900
Name:MY HOUSE LLC
Entity Type:Organization
Organization Name:MY HOUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:UMA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGULAPALLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-455-0623
Mailing Address - Street 1:1819 E SOUTHERN AVE STE D21
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-5244
Mailing Address - Country:US
Mailing Address - Phone:480-461-0068
Mailing Address - Fax:480-461-0069
Practice Address - Street 1:1819 E SOUTHERN AVE STE D21
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-5244
Practice Address - Country:US
Practice Address - Phone:480-461-0068
Practice Address - Fax:480-461-0069
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARE GROUP AZ
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care