# STATE 48 HOME HEALTH OF SIERRA VISTA LLC

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

## Provider details

- **NPI number:** 1336944891
- **Authorized official:** MOHAMMED AHMED (MANAGER)
- **Authorized official phone:** (702) 445-1354

## Contact information

- **Practice address:** 400 W FRY BLVD STE 12A, SIERRA VISTA, AZ 85635-1760
- **Practice address phone:** (520) 685-3071
- **Mailing address:** 400 W FRY BLVD STE 12A, SIERRA VISTA, AZ 85635-1760
- **Mailing address phone:** (520) 685-3071

## Taxonomy

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

## Other

- **Enumeration date:** 02/18/2025
- **Last updated:** 02/18/2025