Provider Demographics
NPI:1619518263
Name:DALIA HOMECARE LLC
Entity Type:Organization
Organization Name:DALIA HOMECARE LLC
Other - Org Name:DALIA HOMECARE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-735-9836
Mailing Address - Street 1:426 W BEAUTIFUL LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-8013
Mailing Address - Country:US
Mailing Address - Phone:612-735-9836
Mailing Address - Fax:602-607-5636
Practice Address - Street 1:426 W BEAUTIFUL LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-8013
Practice Address - Country:US
Practice Address - Phone:612-735-9836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-04
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care