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General NPI Number Information
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NPI Number | 1134715501
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Entity Type | Organization
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Legal Business Name | HOME SWEET HOME HEALTH AGENCY
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Dates
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Enumeration Date | 12/18/2020
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 4535 S LAKESHORE DR STE 1A
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City | TEMPE
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State | AZ
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Zip | 85282-8342
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Country | US
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Telephone | 480-459-4457
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7342
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City | TEMPE
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State | AZ
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Zip | 85281-0012
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Country | US
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Telephone | 480-639-7187
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | FAHTIMAH ROSE DAVIS
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Credential | RN
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Telephone | 480-459-4457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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