1235521212 NPI number — AMERCO HEALTH ENTERPRISE, INC

Table of content: MR. TYREE EDWARD MILLER MSW, LCSW (NPI 1720297989)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235521212 NPI number — AMERCO HEALTH ENTERPRISE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERCO HEALTH ENTERPRISE, INC
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:
1235521212
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/27/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18806 ACADEMY CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92648-1514
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-655-3985
Provider Business Mailing Address Fax Number:
714-921-3865

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1006 E BASTANCHURY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FULLERTON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92835-2782
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-921-3870
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/27/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
AMER
Authorized Official First Name:
ANNE
Authorized Official Middle Name:
AHMAD
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
714-655-3985

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  20A10596 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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