Healthcare Provider Details

I. General information

NPI: 1407326481
Provider Name (Legal Business Name): NJS HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2018
Last Update Date: 12/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21600 N BRADFORD DR
MARICOPA AZ
85138-9007
US

IV. Provider business mailing address

21600 N BRADFORD DR
MARICOPA AZ
85138-9007
US

V. Phone/Fax

Practice location:
  • Phone: 520-788-1691
  • Fax:
Mailing address:
  • Phone: 520-788-1691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279H0200X
TaxonomyHome Health Registered Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER G. LE
Title or Position: OWNER
Credential: RRT
Phone: 520-788-1691