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NPI Code Detail

MEDICARE: TALAS HARBOR AT YUMA LLC

MEDICARE: TALAS HARBOR AT YUMA LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1283Q00000XPsychiatric Hospital

General Provider Information

NPI Number : 1962176982
Entity Type Code : Organization
Provider Name (Legal Business Name) : TALAS HARBOR AT YUMA LLC
Provider Business Mailing Address
First Line : 2813 63RD AVENUE CT NW
Second Line :
City : GIG HARBOR
State : WA
Zip : 98335-8455
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7201 E 31ST PL
Second Line :
City : YUMA
State : AZ
Zip : 85365-8394
Country : US
Telephone Number : 253-241-4992
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : RONLD STEWART
Credential :
Telephone Number : 253-241-4992
Provider Enumeration Date : 08/03/2021
Last Update Date : 08/03/2021

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