MEDICARE: ANOTHER DAWN LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1194535229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANOTHER DAWN LLC

Provider Business Mailing Address
First Line	:	8603 N 22ND AVE APT 220
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-4276
Country	:	US
Telephone Number	:	267-290-9631
Fax Number	:

Provider Business Practice Location Address
First Line	:	8603 N 22ND AVE APT 220
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-4276
Country	:	US
Telephone Number	:	267-290-9631
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DANIE ONTOUA
Credential	:
Telephone Number	:	267-290-9631

Provider Enumeration Date	:	01/10/2025
Last Update Date	:	01/10/2025

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Directions to “ANOTHER DAWN LLC ” Practice Location

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