NPI 1700010154

Jagged Rock Rehab Travelers

Organisation Early Intervention Provider Agency Yuma, AZ

Practice location

Address: 10667 S Avenue 10 E # 46, Yuma, AZ 85365-7008
Phone: (605) 430-9361

Authorised official

Name: Monika Shumbopoissant
Title: Owner
Phone: (605) 430-9361

Registered specialties

Early Intervention Provider Agency Primary

Agencies Taxonomy 252Y00000X Licence DDD704011 (AZ)

Other Early Intervention Provider Agency providers in Arizona →

Registry record

NPI: 1700010154
Entity type: Organization
NPI issued: 13 May 2009
Record last updated: 13 May 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.