=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518854330
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AIDS HEALTHCARE FOUNDATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/23/2025
-----------------------------------------------------
Last Update Date | 06/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3009 S 40TH ST
-----------------------------------------------------
City | TACOMA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98409-5632
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-238-1677
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6255 W SUNSET BLVD FL 21
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90028-7422
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-860-5200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF OF MANAGED CARE
-----------------------------------------------------
Name | DONNA STIDHAM
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 323-860-5325
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------