Organization · NPI-2

Jr Renaissance Health Services

Clinic/Center · Bullhead City, AZ

NPI number1245985027
StatusActive
Last updated in NPPESFeb 19, 2022

Details

NPI
1245985027
Entity type
Organization (NPI-2)
Legal business name
Jr Renaissance Health Services
Organization subpart
No
Enumeration date
Feb 19, 2022
Certification date
Feb 19, 2022
Last updated
Feb 19, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

1957 Hway 95 Ste 23
Bullhead City, AZ 86442-6744

Phone 928-234-3834 · Fax 602-792-7270

Mailing address

Po Box 90182
Henderson, NV 89009-0182

Phone 928-234-3834 · Fax 602-792-7270

Authorized official

Carmen J. Soto
Office Manager
9282343834

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