Organization
GRAND DESERT HOME HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELMIRA KOHAN (CEO)
(602) 274-8800
Entity
Organization
Contact information
Practice address
29 W THOMAS RD STE 204, PHOENIX, AZ 85013-4412
(602) 274-8800
Mailing address
29 W THOMAS RD STE 204, PHOENIX, AZ 85013-4412
(602) 274-8800
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
555574
—
AZ
Enumeration date
09/27/2018
Last updated
03/18/2021
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