1982015525 NPI number — HUMANITY HEALTH PROVIDERS, LLC

Table of content: (NPI 1982015525)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982015525 NPI number — HUMANITY HEALTH PROVIDERS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUMANITY HEALTH PROVIDERS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982015525
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 S CALVARY WAY STE B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COTTONWOOD
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
86326-4165
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
928-649-6557
Provider Business Mailing Address Fax Number:
928-634-6389

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
657 E COTTONWOOD ST
Provider Second Line Business Practice Location Address:
UNIT 9
Provider Business Practice Location Address City Name:
COTTONWOOD
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86326-4407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-649-6557
Provider Business Practice Location Address Fax Number:
928-649-0228
Provider Enumeration Date:
05/16/2014

Additional Information

Authorized Official

Authorized Official Last Name:
MORROW
Authorized Official First Name:
JAENENE
Authorized Official Middle Name:
K
Authorized Official Title or Position:
BUSINESS ADMINISTRATOR
Authorized Official Telephone Number:
928-295-7377

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RG0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com