Provider Demographics
NPI:1306443197
Name:DA HOMES LLC
Entity type:Organization
Organization Name:DA HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/BHT
Authorized Official - Prefix:
Authorized Official - First Name:DEPHANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-312-8111
Mailing Address - Street 1:8027 S 24TH WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-7013
Mailing Address - Country:US
Mailing Address - Phone:623-312-8111
Mailing Address - Fax:
Practice Address - Street 1:8027 S 24TH WAY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-7013
Practice Address - Country:US
Practice Address - Phone:623-312-8111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-05
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZBH6385OtherADHS