Healthcare Provider Details

I. General information

NPI: 1518876424
Provider Name (Legal Business Name): DELORDS RENEWED HOPE HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 W IRON AVE
MESA AZ
85210-6025
US

IV. Provider business mailing address

PO BOX 503
QUEEN CREEK AZ
85142-1809
US

V. Phone/Fax

Practice location:
  • Phone: 480-685-8960
  • Fax:
Mailing address:
  • Phone: 480-685-8960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: BELINDA FOMBA
Title or Position: OWNER
Credential: MSN,APRN,PMHNP-BC
Phone: 480-685-8960