Provider Demographics
NPI:1548582703
Name:SONORAN HOME HEALTH, LLC
Entity Type:Organization
Organization Name:SONORAN HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:GARCIA
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:623-444-5784
Mailing Address - Street 1:15535 N REEMS RD STE 125-17
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-9580
Mailing Address - Country:US
Mailing Address - Phone:623-444-5784
Mailing Address - Fax:623-444-5600
Practice Address - Street 1:15535 N REEMS RD STE 125-17
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-9580
Practice Address - Country:US
Practice Address - Phone:623-444-5784
Practice Address - Fax:623-444-5600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHHA4771251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health