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General NPI Number Information
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NPI Number | 1699726570
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Entity Type | Organization
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Legal Business Name | NH TWENTYNINE PALMS
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 1145 STURGIS ROAD
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City | TWENTYNINE PALMS
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State | CA
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Zip | 92278
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Country | US
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Telephone | 760-830-2121
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Fax | 760-830-2714
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Provider Business Mailing Address
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Address Line | 1145 STURGIS ROAD
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City | TWENTYNINE PALMS
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State | CA
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Zip | 92278
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Country | US
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Telephone | 760-830-2121
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Fax | 760-830-2714
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Authorized Official
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Title or Position | UBO MANAGER
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Name | STEPHANIE SULLIVAN
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Credential |
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Telephone | 760-830-2121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2865M2000X
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Taxonomy Name | Military General Acute Care Hospital
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License Number |
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License Number State |
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