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General NPI Number Information
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NPI Number | 1164311163
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Entity Type | Organization
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Legal Business Name | COPPER VALLEY INTEGRATED HEALTH LLC
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 7317 W ST CATHERINE AVE
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City | LAVEEN
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State | AZ
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Zip | 85339-7017
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Country | US
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Telephone | 207-409-4027
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Fax |
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Provider Business Mailing Address
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Address Line | 7317 W ST CATHERINE AVE
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City | LAVEEN
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State | AZ
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Zip | 85339-7017
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Country | US
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Telephone | 207-409-4027
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE DIRECTOR
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Name | MR. LUC-ARMAND NINGUMIRIZE
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Credential |
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Telephone | 207-409-4027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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