Individual
RACHA MAYTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11225 N 28TH DR, PHOENIX, AZ 85029-5606
(623) 418-1234
Mailing address
11225 N 28TH DR, PHOENIX, AZ 85029-5606
(623) 418-1234
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
088914
ACCESS PROVIDER
AZ
Enumeration date
04/22/2021
Last updated
05/05/2023
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