Provider Demographics
NPI:1134529282
Name:MARHABA HOME CARE LLC
Entity type:Organization
Organization Name:MARHABA HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARHABA HOME CARE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEDHIN
Authorized Official - Middle Name:DEBESAY
Authorized Official - Last Name:ZERO
Authorized Official - Suffix:
Authorized Official - Credentials:CAREGIVER/OWNER CNA
Authorized Official - Phone:623-398-6059
Mailing Address - Street 1:15244 W WATSON LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-7040
Mailing Address - Country:US
Mailing Address - Phone:623-398-6059
Mailing Address - Fax:623-398-8081
Practice Address - Street 1:15244 W WATSON LN
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-7040
Practice Address - Country:US
Practice Address - Phone:623-398-6059
Practice Address - Fax:623-398-8081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL9436H320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities