Provider Demographics
NPI:1770843518
Name:SANTA RITA HOME HEALTH, LLC
Entity Type:Organization
Organization Name:SANTA RITA HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-352-3019
Mailing Address - Street 1:150 N LA CANADA DR
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-3129
Mailing Address - Country:US
Mailing Address - Phone:520-625-0178
Mailing Address - Fax:520-648-5099
Practice Address - Street 1:150 N LA CANADA DR
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-3129
Practice Address - Country:US
Practice Address - Phone:520-625-0178
Practice Address - Fax:520-648-5099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-28
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ037446Medicare Oscar/Certification