Doctor Name: | JERI WILHITE WILLIAMS |
NPI Number: | 1548550437 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ALHM |
License Number: | AL4173H |
Business Practice Address: | 3862 N Melody St Kingman, AZ - 864093305 |
Business Phone Number: | 9287579145 |
Business Fax Number: | 9287579145 |
Mailing Address: | 3862 N Melody St, KINGMAN |
State: | AZ |
Postal Code: | 864093305 |
Phone Number: | 9287579145 |
Fax Number: | 9287579145 |
NPI Enumeration Date: | 04/12/2011 |
NPI Last Update Date: | 04/12/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | AL4173H |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Assisted Living Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |