| Elba Healthcare, Llc | |
|
2450 S 4th Ave Suite 201 Yuma AZ 85364-8573 | |
| (928) 257-4897 | |
| (866) 534-1701 |
| Full Name | Elba Healthcare, Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 2450 S 4th Ave, Yuma, Arizona |
| Authorized Official Name and Position | Carl A Bonacci (OWNER) |
| Authorized Official Contact | 9282574897 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elba Healthcare, Llc 1349 E Colter St Phoenix AZ 85014-3048 Ph: (928) 257-4897 | Elba Healthcare, Llc 2450 S 4th Ave Suite 201 Yuma AZ 85364-8573 Ph: (928) 257-4897 |
| NPI Number | 1487830758 |
|---|---|
| Provider Enumeration Date | 01/16/2008 |
| Last Update Date | 01/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487830758 | NPI | - | NPPES |
| 872003 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 3376 (Arizona) | Primary |
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