Provider Demographics
NPI:1609479898
Name:VERDE COMMUNITY HEALTHCARE LLC
Entity Type:Organization
Organization Name:VERDE COMMUNITY HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAENENE
Authorized Official - Middle Name:K
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-295-7377
Mailing Address - Street 1:657 E COTTONWOOD ST STE 10
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-4407
Mailing Address - Country:US
Mailing Address - Phone:928-634-6369
Mailing Address - Fax:928-649-0228
Practice Address - Street 1:657 E COTTONWOOD ST STE 10
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-4407
Practice Address - Country:US
Practice Address - Phone:928-634-6369
Practice Address - Fax:928-649-0228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health