=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568526770
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAGGAI HEALTHCARE CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/21/2006
-----------------------------------------------------
Last Update Date | 01/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 633 E RAY RD STE 118
-----------------------------------------------------
City | GILBERT
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85296-4205
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-943-5963
-----------------------------------------------------
Fax | 602-943-4516
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 633 E RAY RD STE 118
-----------------------------------------------------
City | GILBERT
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85296-4205
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-943-5963
-----------------------------------------------------
Fax | 602-943-4516
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | BRANDON LANG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 602-943-5963
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | HHA3650
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------