Healthcare Provider Details

I. General information

NPI: 1962332601
Provider Name (Legal Business Name): PHOENIX HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9131 S TERRY LN
TEMPE AZ
85284-3813
US

IV. Provider business mailing address

9131 S TERRY LN
TEMPE AZ
85284-3813
US

V. Phone/Fax

Practice location:
  • Phone: 916-260-8892
  • Fax:
Mailing address:
  • Phone: 916-260-8892
  • 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: ANEESHKUMAR CHELLISSERY SASI
Title or Position: OWNER
Credential: MD
Phone: 916-260-8892