Provider Demographics
NPI:1972339182
Name:HERNANDEZ, VALERIE AURORA (ASST LIVING MANAGER)
Entity type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:AURORA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:ASST LIVING MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1281
Mailing Address - Street 2:
Mailing Address - City:THATCHER
Mailing Address - State:AZ
Mailing Address - Zip Code:85552-1281
Mailing Address - Country:US
Mailing Address - Phone:928-322-1770
Mailing Address - Fax:
Practice Address - Street 1:1500 E WHIRLWIND WAY
Practice Address - Street 2:
Practice Address - City:SAFFORD
Practice Address - State:AZ
Practice Address - Zip Code:85546-2181
Practice Address - Country:US
Practice Address - Phone:928-322-1770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility