Provider Demographics
NPI:1255616082
Name:D.A. HOME HEALTH MANAGEMENT LLC
Entity type:Organization
Organization Name:D.A. HOME HEALTH MANAGEMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DENNISA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARDELEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-703-8151
Mailing Address - Street 1:19820 N 7TH ST STE 210
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-1694
Mailing Address - Country:US
Mailing Address - Phone:602-703-8151
Mailing Address - Fax:602-753-9525
Practice Address - Street 1:19820 N 7TH ST STE 210
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-1694
Practice Address - Country:US
Practice Address - Phone:602-703-8151
Practice Address - Fax:602-753-9525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-12
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health