Organization
TINY RESIDENCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYJANE O LUHUMBU NP (PRESIDENT/ OWNER)
(520) 350-0123
Entity
Organization
Contact information
Practice address
1354 E RACINE DR, CASA GRANDE, AZ 85122-6786
(520) 553-9964
(520) 650-2331
Mailing address
1374 E 10TH PL, CASA GRANDE, AZ 85122-3676
(520) 350-0123
(520) 650-2331
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
Other
Enumeration date
04/18/2023
Last updated
04/18/2023
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