Healthcare Provider Details
I. General information
NPI: 1790612976
Provider Name (Legal Business Name): CALMWATER HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16042 N 32ND ST STE D9
PHOENIX AZ
85032-0028
US
IV. Provider business mailing address
16042 N 32ND ST STE D9
PHOENIX AZ
85032-0028
US
V. Phone/Fax
- Phone: 602-600-0010
- Fax:
- Phone: 602-600-0010
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
YARYNA
LICHKO
Title or Position: CEO
Credential:
Phone: 602-600-0010