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GRAND DESERT HOME HEALTH LLC NPI 1083199806


NPI Information

NPI: 1083199806
Provider Name: GRAND DESERT HOME HEALTH, LLC
Classification: Home Health - 251E00000X
Entity Type: Organization

CLIA Number: 03D2151432

Address:
29 W THOMAS RD STE 204
PHOENIX, AZ
ZIP 85013
Phone: (602) 274-8800
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GRAND DESERT HOME HEALTH, LLC is a home health in Phoenix, AZ. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. GRAND DESERT HOME HEALTH, LLC NPI is 1083199806. The provider is registered as an organization entity type.

The provider's business location address is:

29 W THOMAS RD STE 204
PHOENIX, AZ
ZIP 85013-412
Phone: (602) 274-8800

The provider's authorized official is Elmira Kohan .
The authorized official title is Ceo and has the following contact phone number (602) 274-8800.

The CLIA number assigned to this NPI record is 03D2151432 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/27/2018 and was last updated on 3/18/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251E00000XHome HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1555574MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.