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4443 E. Broadway Claypool AZ 85532 | |
(928) 425-9244 | |
(928) 425-9249 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 4443 E. Broadway, Claypool, Arizona |
Authorized Official Name and Position | Edmundo Hidalgo (CEO) |
Authorized Official Contact | 6022570700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1112 E. Buckeye Rd. Phoenix AZ 85034 Ph: (602) 257-0700 | 4443 E. Broadway Claypool AZ 85532 Ph: (928) 425-9244 |
NPI Number | 1679757553 |
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Provider Enumeration Date | 12/27/2007 |
Last Update Date | 03/17/2011 |
Identifier | Type | State | Issuer |
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1679757553 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | BH-2823 (Arizona) | Primary |