Provider Demographics
NPI:1851973952
Name:HAYSO HOMES LLC
Entity Type:Organization
Organization Name:HAYSO HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NOOR
Authorized Official - Middle Name:
Authorized Official - Last Name:NOOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-314-5363
Mailing Address - Street 1:2245 E VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-1347
Mailing Address - Country:US
Mailing Address - Phone:602-314-5363
Mailing Address - Fax:
Practice Address - Street 1:2245 E VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-1347
Practice Address - Country:US
Practice Address - Phone:602-697-6519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAYSO HOMES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-27
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health