Provider Demographics
NPI:1184459638
Name:HEART OF YUMA
Entity type:Organization
Organization Name:HEART OF YUMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAREGIVER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:FUENTES
Authorized Official - Last Name:OREJEL
Authorized Official - Suffix:
Authorized Official - Credentials:CAREGIVER
Authorized Official - Phone:928-975-2480
Mailing Address - Street 1:373 S 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-2134
Mailing Address - Country:US
Mailing Address - Phone:928-975-2480
Mailing Address - Fax:
Practice Address - Street 1:5363 S TIERRA BONITA BLVD
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-7779
Practice Address - Country:US
Practice Address - Phone:928-975-2480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty