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537 S Main St Snowflake AZ 85937-5279 | |
| (928) 537-5315 | |
| (928) 892-5828 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 537 S Main St, Snowflake, Arizona |
| Authorized Official Name and Position | Michele A Hospodka (BILLING AND CREDENTIALING SPECIALIS) |
| Authorized Official Contact | 9285375315 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1801 W Deuce Of Clubs Ste 100 Show Low AZ 85901-2704 Ph: (928) 537-5315 | 537 S Main St Snowflake AZ 85937-5279 Ph: (928) 537-5315 |
| NPI Number | 1952891970 |
|---|---|
| Provider Enumeration Date | 05/15/2018 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952891970 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | OTC8913 (Arizona) | Primary |
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