MEDICARE: DESERT BREEZE HEALTHCARE 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	343900000X	Non-emergency Medical Transport (VAN)
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1437017159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESERT BREEZE HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	4801 S LAKESHORE DR STE 108
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7156
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4801 S LAKESHORE DR STE 108
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7156
Country	:	US
Telephone Number	:	480-750-1440
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	AMBER L TUELLER
Credential	:
Telephone Number	:	208-207-2726

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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