# MIRAGE HOME HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295395549
- **Authorized official:** JASON A MABBAYAD RN (ADMINISTRATOR)
- **Authorized official phone:** (760) 799-4025

## Contact information

- **Practice address:** 2145 E TAHQUITZ CANYON WAY STE 3, PALM SPRINGS, CA 92262-7020
- **Practice address phone:** (760) 322-3700
- **Practice address fax:** (760) 322-3710
- **Mailing address:** 2145 E TAHQUITZ CANYON WAY STE 3, PALM SPRINGS, CA 92262-7020
- **Mailing address phone:** (760) 322-3700
- **Mailing address fax:** (760) 322-3710

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 06/19/2019
- **Last updated:** 06/19/2019