Organization
DA HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEPHANNIE JOUNG (ADMINISTRATOR/BHT)
(623) 312-8111
Entity
Organization
Contact information
Practice address
8027 S 24TH WAY, PHOENIX, AZ 85042-7013
(623) 312-8111
Mailing address
8027 S 24TH WAY, PHOENIX, AZ 85042-7013
(623) 312-8111
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
273Y00000X
Rehabilitation Hospital Unit
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH6385
ADHS
AZ
Enumeration date
10/05/2020
Last updated
03/23/2021
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