MINELL HENDERSON (NPI# 1932646247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932646247 |
| Entity Type | Individual |
| Full Name | MINELL HENDERSON |
| Practice Address |
1320 E Palo Verde Dr. Casa Grande AZ 85122 |
| Mailing Address |
Intermountain Centers for Human Development Inc Po Box 86537 Tucson AZ 85754-6537 |
| Practice Telephone | 4808459222 |
| Mailing Telephone | 4808459222 |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2020-09-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | 9233373 | AZ | Other Service Providers |
| N | 385H00000X | Respite Care | BH5085 | AZ | Respite Care Facility |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AZ DEPT OF HEALTH SERVICES | BH5085 | 01 |
| Street Address |
1320 E PALO VERDE DR. |
| City | CASA GRANDE |
| State | AZ |
| Zip Code | 85122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043857097 | Karen M Garcia | Registered Nurse | 2631 N Brown Avenue, Casa Grande, AZ 85122 | 2019-12-09 |
| 1063060291 | Martha Bollin | Registered Nurse | 2631 N. Brown Ave., Casa Grande, AZ 85122 | 2019-08-30 |
| 1841846920 | Banner Imaging Services LLC | Radiology | 1828 E. Florence Blvd Bldg B Ste 118 & 128, Suite 118 and 128, Casa Grande, AZ 85122 | 2019-08-14 |
| 1629532692 | Kirk Lee Mackley | Physical Therapist | Vibrant Care, 1355 E Florence Blvd #137, Casa Grande, AZ 85122 | 2019-01-24 |
| 1205307436 | Natalie T Trujillo | Physician Assistant | 301 E Cottonwood Ln Ste 1&2, Casa Grande, AZ 85122 | 2018-12-16 |
| 1710455860 | Community Intervention Associates, Inc | Clinic/Center | 1667 N. Trekell Rd, Suite 101 & 102, Casa Grande, AZ 85122 | 2018-11-07 |
| 1245728302 | Jenkins Chiropractic LLC | Chiropractor | 1891 N Trekell Rd Ste 2, Casa Grande, AZ 85122 | 2018-04-24 |
| 1497242408 | Kelly Winnett | Naturopath | 1415 N Trekell Rd Ste 102, Casa Grande, AZ 85122 | 2018-04-16 |
| 1851895783 | Michael Brubaker Counseling | Community/Behavioral Health | 1927 N. Trekell Rd, Ste D, Casa Grande, AZ 85122 | 2018-03-23 |
| 1770095317 | Walmart Stores Inc. | Pharmacy | 1741 E. Florence Blvd, Casa Grande, AZ 85122 | 2017-11-03 |
| Find all providers in zip 85122 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487945960 | Carol Ann Johnson | Contractor | 2054 N Thornton Rd, Space 105, Casa Grande, AZ 85122-7853 | 2011-05-02 |
| 1366774762 | Haisheba Pacifica Jenness | Contractor | 1355 E Angie St, Casa Grande, AZ 85122-3293 | 2010-02-10 |
| 1194972422 | Timothy Wayne Stanford | Contractor | 1022 N Brown Ave, Casa Grande, AZ 85222-2601 | 2008-08-18 |
| 1003083122 | Carla Mae Neill | Contractor | 10948 N Tuzigoot Dr, Casa Grande, AZ 85222-7826 | 2008-05-08 |
| 1245406834 | Albert Poma | Contractor | 1598 E Desert Breeze Dr, Casa Grande, AZ 85222-5812 | 2008-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092777 | Anthony Darryl Conner | Contractor | 127 W Hayden Park Rd, San Tan Valley, AZ 85143-6079 | 2020-10-29 |
| 1043825698 | Jacob Smith | Contractor | 960 W Southern Ave Apt 2006, Mesa, AZ 85210-4968 | 2020-09-10 |
| 1871102533 | Joanna Hinojosa | Contractor | 3152 E San Manuel Rd, San Tan Valley, AZ 85143-4537 | 2020-07-29 |
| 1427672799 | Deborah Marie Winn | Contractor | 2960 N Swan Rd Ste 214, Tucson, AZ 85712-6020 | 2020-06-03 |
| 1023637345 | Jamie Roshun Dawson | Contractor | 13229 S 48th St Apt 3051, Phoenix, AZ 85044 | 2020-04-16 |
| 1861028383 | Susan Fruchtman | Contractor | 17797 N Perimeter Dr Ste 109, Scottsdale, AZ 85255-5455 | 2020-03-16 |
| 1689204638 | Marcela Becerra | Contractor | 38061 W La Paz St, Maricopa, AZ 85138-4187 | 2020-01-17 |
| 1205476975 | David S Cole | Contractor | 4344 E Juanita Ave, Gilbert, AZ 85234-0362 | 2020-01-10 |
| 1255977633 | Lisa Chism | Contractor | 1316 S Owl Dr, Gilbert, AZ 85296-8470 | 2019-11-21 |
| 1699310003 | Michael Simon Jr. | Contractor | 20759 N Grantham Rd, Maricopa, AZ 85138-6745 | 2019-11-08 |
| Find all providers with the same taxonomy | ||||
| City | CASA GRANDE |
| Zip Code | 85122 |
Please comment or provide details below to improve the information on MINELL HENDERSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.