RUDOLFO BRUCE CAMPOS NPI 1669540555

NPI Information

NPI: 1669540555
Provider Name: RUDOLFO BRUCE CAMPOS
Classification: Respite Care - 385HR2055X
Entity Type: Individual

Specialization: Respite Care, Mental Illness, Child

Address:
114 MCCORMICK CANYON
CLIFTON, AZ
ZIP 85533
Phone: (928) 865-3109
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Rudolfo Bruce Campos is a respite care and mental illness and child respite care in Clifton, AZ. The provider is a facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers. Rudolfo Bruce Campos NPI is 1669540555. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

114 MCCORMICK CANYON
CLIFTON, AZ
ZIP 85533
Phone: (928) 865-3109

The enumeration date for this NPI number is 12/1/2006 and was last updated on 7/25/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	385HR2055X	Respite Care	Respite Care, Mental Illness, Child		ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	758287	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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