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General NPI Number Information
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NPI Number | 1811853633
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Entity Type | Organization
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Legal Business Name | YESHUA'S SANCTUARY
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Dates
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Enumeration Date | 12/25/2025
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Last Update Date | 12/25/2025
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Provider Practice Location Address
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Address Line | 1700 N UNIVERSITY DR STE 220
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8970
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Country | US
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Telephone | 714-351-1078
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 N UNIVERSITY DR STE 220
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8970
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | SHANICE CLAYTON
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Credential |
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Telephone | 786-267-1065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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