Desert Haven Home Care LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

DESERT HAVEN HOME CARE LLC

Doing business as

Desert Haven Home Care LLC

Practice address

4123 N 21St St
Phoenix, AZ 85016-6109

Phone

(602) 670-9326

Fax

(602) 393-9097

NPI assigned

Dec 8, 2020

Last updated

Dec 8, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Christopher D. Zambakari, BS, MBA, MIS, LP.D.

Title

Ceo

Phone

(602) 670-9326

Specialties & licenses 1

Addresses

Other names 1

• Desert Haven Home Care LLC Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607385600000",
    "number": "1376149070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4123 N 21ST ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166109",
            "telephone_number": "602-670-9326",
            "fax_number": "602-393-9097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 N 21ST ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166109",
            "telephone_number": "602-670-9326",
            "fax_number": "602-393-9097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4719 W Harmont Dr",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853026416",
            "country_code": "US",
            "telephone_number": "602-670-9326",
            "fax_number": "602-393-9097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DESERT HAVEN HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A",
        "authorized_official_last_name": "ZAMBAKARI",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-670-9326",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "BS, MBA, MIS, LP.D."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Haven Home Care LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.