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General NPI Number Information
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NPI Number | 1396978268
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Entity Type | Organization
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Legal Business Name | YOUNG HEARTS OF YUMA, INC
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Dates
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Enumeration Date | 08/26/2009
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Last Update Date | 08/26/2009
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Provider Practice Location Address
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Address Line | 2051 W 25TH ST
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City | YUMA
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State | AZ
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Zip | 85364-6912
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Country | US
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Telephone | 928-317-1119
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Fax | 928-344-2270
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Provider Business Mailing Address
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Address Line | 2051 W 25TH ST
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City | YUMA
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State | AZ
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Zip | 85364-6912
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Country | US
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Telephone | 928-317-1119
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Fax | 928-344-2270
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAHER MARK AWAR
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Credential | M.D.
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Telephone | 928-317-1119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State | AZ
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