Provider Demographics
NPI:1740985423
Name:HIGH DESERT HOME HEALTH LLC
Entity type:Organization
Organization Name:HIGH DESERT HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COLETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-520-7326
Mailing Address - Street 1:10720 S WHIRLAWAY LN
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-4613
Mailing Address - Country:US
Mailing Address - Phone:801-520-7326
Mailing Address - Fax:
Practice Address - Street 1:10720 S WHIRLAWAY LN
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84092-4613
Practice Address - Country:US
Practice Address - Phone:801-520-7326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health