Organization
DA HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEPHANNIE JOUNG (OWNER/ADMINISTRATOR)
(623) 312-8111
Entity
Organization
Contact information
Practice address
742 E GARNET AVE, MESA, AZ 85204-5713
(623) 312-8111
Mailing address
742 E GARNET AVE, MESA, AZ 85204-5713
(623) 312-8111
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH5804
STATE OF ARIZONA DEPARTMENT OF HEALTH
AZ
Enumeration date
07/11/2019
Last updated
03/23/2021
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