Provider Demographics
NPI:1831373893
Name:BECKY HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:BECKY HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:AGURU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-750-9461
Mailing Address - Street 1:9966 W. MACKENZIE DRIVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-2508
Mailing Address - Country:US
Mailing Address - Phone:602-750-9461
Mailing Address - Fax:623-414-3078
Practice Address - Street 1:9966 W MACKENZIE DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-2508
Practice Address - Country:US
Practice Address - Phone:602-750-9461
Practice Address - Fax:623-414-3078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty