Sao Brima
Individual provider Active NPI Child Intellectual and/or Developmental Disabilities Respite Care · Youngtown, AZ
NPI 1356004709 · NPPES record last updated Jan 31, 2022
Key facts
- NPI
- 1356004709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X
- Practice address
- 11615 W Hackbarth Dr
Youngtown, AZ 85363-1746 - Phone
- (480) 207-8904
- NPI assigned
- Oct 21, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Titans Home Healthcare LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | |||
| Home Health Aide |
374U00000X | |||
| Respite Care | 385H00000X | |||
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X | Yes |
Addresses
Primary practice location
11615 W Hackbarth Dr
Youngtown, AZ 85363-1746
Mailing address
11615 W Hackbarth Dr
Youngtown, AZ 85363-1746
Phone (480) 207-8904
Other providers in Youngtown, AZ
- Atlantis Medical Specialist Az, PLLC
- Avantgarde Cardiovascular Services PC
- Ayodeji Ayoola
- Adriana Del Carmen Bedoya
- R Barnabas Bickerton
- Karen L Brozik
- James Carriger
- Robert Wallace Clark Jr.
- Connections Christian Counseling, LLC
- John E Cooper II
All providers in Youngtown, AZ · Child Intellectual and/or Developmental Disabilities Respite Care in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.