Ahehee' Shidine'E Homecare LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

AHEHEE' SHIDINE'E HOMECARE LLC

Practice address

7550 N 19TH Ave Ste 205
Phoenix, AZ 85021-7981

Phone

(602) 644-1707

Fax

(928) 318-8777

NPI assigned

Oct 26, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Vanessa Tullie

Title

Owner/Manager

Phone

(602) 687-3110

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626739200000",
    "number": "1003383175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7550 N 19TH AVENUE",
            "address_2": "SUITE 205",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850216997",
            "telephone_number": "602-644-1707",
            "fax_number": "928-318-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7550 N 19TH AVE STE 205",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850217981",
            "telephone_number": "602-644-1707",
            "fax_number": "928-318-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHEHEE' SHIDINE'E HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-26",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A",
        "authorized_official_last_name": "TULLIE",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "602-687-3110",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "429782",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.