Healthcare Provider Details

I. General information

NPI: 1285598029
Provider Name (Legal Business Name): EAST VALLEY FEEDING THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8131 S KENWOOD LN
TEMPE AZ
85284-1717
US

IV. Provider business mailing address

8131 S KENWOOD LN
TEMPE AZ
85284-1717
US

V. Phone/Fax

Practice location:
  • Phone: 602-697-6523
  • Fax:
Mailing address:
  • Phone: 602-697-6523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER URICH
Title or Position: OWNER
Credential: OTR/L
Phone: 602-697-6523