Ana Aguayo

Individual provider Active NPI Assisted Living Facility · Yuma, AZ

NPI 1669186128 · NPPES record last updated Jan 10, 2023

Key facts

NPI
1669186128
Entity type
Individual (NPI type 1)
Primary specialty
Assisted Living Facility 310400000X
License
AL11946H (AZ)
Practice address
2498 S 43Rd Dr
Yuma, AZ 85364-9271
Phone
(760) 554-2047
NPI assigned
Jan 10, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
AL11946HAZMDAssisted Living Facility

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL11946H AZ Yes

Addresses

Primary practice location

2498 S 43Rd Dr
Yuma, AZ 85364-9271

Mailing address

2498 S 43Rd Dr
Yuma, AZ 85364-9271
Phone (760) 554-2047

Other identifiers

IdentifierTypeStateIssuer
164599MedicaidAZ

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL direct Direct

Other providers in Yuma, AZ

All providers in Yuma, AZ · Assisted Living Facility in Arizona

Sources for this page

Verify at the official NPI Registry.