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General NPI Number Information
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NPI Number | 1659965291
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Entity Type | Organization
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Legal Business Name | NESHAMA INC.
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Dates
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Enumeration Date | 02/24/2021
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Last Update Date | 02/24/2021
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Provider Practice Location Address
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Address Line | 12402 N 102ND ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-5106
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Country | US
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Telephone | 651-295-0056
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Fax |
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Provider Business Mailing Address
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Address Line | 364 S SMITH RD
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City | TEMPE
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State | AZ
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Zip | 85281-3092
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Country | US
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Telephone | 480-729-6537
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LAURA JANDL
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Credential |
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Telephone | 651-295-0056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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