| Edventures Group | |
|
Hwy 59 And Hc 61 P.o. 5050-ptt Edventures Program C/o Rough Rock High School Chinle AZ 86503 | |
| (520) 907-6890 | |
| (801) 944-2940 |
| Full Name | Edventures Group |
|---|---|
| Speciality | Community/behavioral Health |
| Location | Hwy 59 And Hc 61 P.o. 5050-ptt, Chinle, Arizona |
| Authorized Official Name and Position | Siamak Khadjenoury (CEO) |
| Authorized Official Contact | 5209076890 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edventures Group 8848 Willow Hills Ct Sandy UT 84093-1889 Ph: (520) 907-6890 | Edventures Group Hwy 59 And Hc 61 P.o. 5050-ptt Edventures Program C/o Rough Rock High School Chinle AZ 86503 Ph: (520) 907-6890 |
| NPI Number | 1790937548 |
|---|---|
| Provider Enumeration Date | 10/10/2008 |
| Last Update Date | 10/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790937548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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