Healthcare Provider Details

I. General information

NPI: 1154936953
Provider Name (Legal Business Name): APACHE HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2020
Last Update Date: 03/09/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S IDAHO RD
APACHE JUNCTION AZ
85119-2379
US

IV. Provider business mailing address

9538 QUAIL CANYON RD
EL CAJON CA
92021-6710
US

V. Phone/Fax

Practice location:
  • Phone: 775-354-9789
  • Fax:
Mailing address:
  • Phone: 619-871-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JULIE IULI
Title or Position: OWNER
Credential:
Phone: 619-871-7777