Provider Demographics
NPI:1134548803
Name:BEE HIVE HOMES OF THE GILA VALLEY
Entity type:Organization
Organization Name:BEE HIVE HOMES OF THE GILA VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:
Authorized Official - Last Name:HEAP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-251-1300
Mailing Address - Street 1:PO BOX 609
Mailing Address - Street 2:
Mailing Address - City:EAGAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85925-0609
Mailing Address - Country:US
Mailing Address - Phone:928-251-1300
Mailing Address - Fax:928-251-1301
Practice Address - Street 1:3150 W. MAIN ST.
Practice Address - Street 2:
Practice Address - City:THATCHER
Practice Address - State:AZ
Practice Address - Zip Code:85552
Practice Address - Country:US
Practice Address - Phone:928-251-1300
Practice Address - Fax:928-251-1301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL9332C302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization