Healthcare Provider Details

I. General information

NPI: 1689059883
Provider Name (Legal Business Name): YVETTE'S HOPE FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 08/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 N. CENTRAL AVE. STE. 1400
PHOENIX AZ
85004
US

IV. Provider business mailing address

40 N CENTRAL AVE STE 1400
PHOENIX AZ
85004-4436
US

V. Phone/Fax

Practice location:
  • Phone: 602-343-3021
  • Fax: 602-343-1801
Mailing address:
  • Phone: 602-343-3021
  • Fax: 602-343-1801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateAZ

VIII. Authorized Official

Name: MRS. YVETTE THOMAS
Title or Position: CEO/FOUNDER
Credential:
Phone: 602-343-3021