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General NPI Number Information
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NPI Number | 1457351967
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Entity Type | Organization
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Legal Business Name | HEALTHCARE MANAGEMENT PROFESSIONAL, INC.
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Dates
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Enumeration Date | 07/26/2005
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Last Update Date | 02/18/2011
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Provider Practice Location Address
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Address Line | 3131 WESTERN AVE
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City | KINGMAN
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State | AZ
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Zip | 86401-0951
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Country | US
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Telephone | 928-718-0718
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Fax | 928-718-1177
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Provider Business Mailing Address
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Address Line | 3131 WESTERN AVE
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City | KINGMAN
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State | AZ
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Zip | 86401-0951
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Country | US
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Telephone | 928-718-0718
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Fax | 928-718-1177
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Authorized Official
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Title or Position | CEO
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Name | DEAN CHARLES KIDDER
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Credential |
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Telephone | 928-718-4852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | NCI 1979
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License Number State | AZ
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