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General NPI Number Information
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NPI Number | 1184459638
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Entity Type | Organization
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Legal Business Name | HEART OF YUMA
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Dates
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Enumeration Date | 09/04/2024
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 5363 S TIERRA BONITA BLVD
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City | YUMA
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State | AZ
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Zip | 85365-7779
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Country | US
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Telephone | 928-975-2480
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Fax |
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Provider Business Mailing Address
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Address Line | 373 S 6TH AVE
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City | YUMA
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State | AZ
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Zip | 85364-2134
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Country | US
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Telephone | 928-975-2480
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Fax |
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Authorized Official
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Title or Position | CAREGIVER
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Name | STEPHANIE FUENTES OREJEL
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Credential | CAREGIVER
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Telephone | 928-975-2480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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