Organization
AHEHEE' SHIDINE'E HOMECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VANESSA TULLIE (OWNER/MANAGER)
(602) 687-3110
Entity
Organization
Contact information
Practice address
7550 N 19TH AVE STE 205, PHOENIX, AZ 85021-7981
(602) 644-1707
(928) 318-8777
Mailing address
7550 N 19TH AVENUE, SUITE 205, PHOENIX, AZ 85021-6997
(602) 644-1707
(928) 318-8777
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
429782
—
AZ
Enumeration date
10/26/2018
Last updated
07/20/2021
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