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20172 E Stagecoach Trl Ste B Mayer AZ 86333-2357 | |
| (928) 632-4399 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 20172 E Stagecoach Trl Ste B, Mayer, Arizona |
| Authorized Official Name and Position | John S. Gilliam (MEDICAL DIRECTOR) |
| Authorized Official Contact | 4806813450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
15029 N Thompson Peak Pkwy Ste B-111 # 438 Scottsdale AZ 85260 Ph: (480) 681-3450 | 20172 E Stagecoach Trl Ste B Mayer AZ 86333-2357 Ph: (928) 632-4399 |
| NPI Number | 1972170322 |
|---|---|
| Provider Enumeration Date | 06/04/2021 |
| Last Update Date | 12/17/2024 |
| Certification Date | 12/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972170322 | NPI | - | NPPES |
Black Canyon Community Health Center Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 17301 E Spring Valley Rd Ste F, Mayer, AZ 86333 Phone: 623-374-0200 Fax: 623-374-5576 |