Healthcare Provider Details

I. General information

NPI: 1336475953
Provider Name (Legal Business Name): PRIORITY AT HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2009
Last Update Date: 11/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4856 E BASELINE RD SUITE 104
MESA AZ
85206-4635
US

IV. Provider business mailing address

9115 E BASELINE RD SUITE C102-13
MESA AZ
85209-7763
US

V. Phone/Fax

Practice location:
  • Phone: 480-280-7685
  • Fax: 480-380-2274
Mailing address:
  • Phone: 480-280-7685
  • Fax: 480-380-2274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. SEAN CADY
Title or Position: OWNER
Credential:
Phone: 480-280-7685