Provider Demographics
NPI:1356218366
Name:T.Y.P. HOME DIALYSIS CARE LLC
Entity type:Organization
Organization Name:T.Y.P. HOME DIALYSIS CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YELLOWHAIR
Authorized Official - Suffix:
Authorized Official - Credentials:CCHT
Authorized Official - Phone:623-565-7569
Mailing Address - Street 1:5115 N DYSART RD
Mailing Address - Street 2:202-445
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-3032
Mailing Address - Country:US
Mailing Address - Phone:844-520-7412
Mailing Address - Fax:
Practice Address - Street 1:5115 N DYSART RD
Practice Address - Street 2:202-445
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-3032
Practice Address - Country:US
Practice Address - Phone:844-520-7412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2472R0900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherRenal DialysisGroup - Single Specialty