Healthcare Provider Details

I. General information

NPI: 1154226173
Provider Name (Legal Business Name): DEHP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1022 E GARFIELD ST
PHOENIX AZ
85006-3236
US

IV. Provider business mailing address

3800 N CENTRAL AVE STE 1010
PHOENIX AZ
85012-1918
US

V. Phone/Fax

Practice location:
  • Phone: 602-566-7627
  • Fax: 714-333-4840
Mailing address:
  • Phone: 602-566-7627
  • Fax: 714-333-4840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOSETTE D SULLINS
Title or Position: CEO
Credential:
Phone: 602-566-7627