Provider Demographics
NPI:1710032727
Name:PLATINUM HEALTHCARE LLC
Entity Type:Organization
Organization Name:PLATINUM HEALTHCARE LLC
Other - Org Name:SIRRI ARIZONA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:V
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:480-777-7075
Mailing Address - Street 1:4515 S MCCLINTOCK DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7376
Mailing Address - Country:US
Mailing Address - Phone:480-777-7075
Mailing Address - Fax:480-777-7119
Practice Address - Street 1:4515 S MCCLINTOCK DR
Practice Address - Street 2:SUITE 208
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7376
Practice Address - Country:US
Practice Address - Phone:480-777-7075
Practice Address - Fax:480-777-7119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4120225100000X
AZ2796225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty