Healthcare Provider Details

I. General information

NPI: 1508787607
Provider Name (Legal Business Name): DESERT DAWN HEALTHCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4539 N 22ND ST # 7124
PHOENIX AZ
85016-4639
US

IV. Provider business mailing address

2542 LESLIE DR NE
ATLANTA GA
30345-1532
US

V. Phone/Fax

Practice location:
  • Phone: 404-664-2503
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TAMARA PRATT
Title or Position: PRESIDENT
Credential:
Phone: 404-664-2503