Provider Demographics
NPI:1336882505
Name:HARMONY PROVIDER CARE LLC
Entity type:Organization
Organization Name:HARMONY PROVIDER CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:
Authorized Official - Last Name:PAIGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-395-0233
Mailing Address - Street 1:15823 N 57TH ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6204
Mailing Address - Country:US
Mailing Address - Phone:480-395-0233
Mailing Address - Fax:
Practice Address - Street 1:10428 W CHICKASAW ST
Practice Address - Street 2:
Practice Address - City:TOLLESON
Practice Address - State:AZ
Practice Address - Zip Code:85353-1387
Practice Address - Country:US
Practice Address - Phone:480-395-0233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children