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1115 Stockton Hill Road Suite 103 & 104 Kingman AZ 86401-6232 | |
| (928) 565-6599 | |
| (928) 529-5180 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Methadone |
| Location | 1115 Stockton Hill Road, Kingman, Arizona |
| Authorized Official Name and Position | Cindy Gaither (REVENUE CYCLE DIRECTOR) |
| Authorized Official Contact | 4809355755 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8444 N 90th St Ste 100 Scottsdale AZ 85258-4437 Ph: (602) 248-8886 | 1115 Stockton Hill Road Suite 103 & 104 Kingman AZ 86401-6232 Ph: (928) 565-6599 |
| NPI Number | 1962069468 |
|---|---|
| Provider Enumeration Date | 05/21/2019 |
| Last Update Date | 06/10/2024 |
| Certification Date | 06/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962069468 | NPI | - | NPPES |
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