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1607 Plantation Rd Mohave Valley AZ 86440-8420 | |
| (928) 346-4679 | |
| (928) 346-4686 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1607 Plantation Rd, Mohave Valley, Arizona |
| Authorized Official Name and Position | Timothy Williams (TRIBAL CHAIRMAN) |
| Authorized Official Contact | 7606294591 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1607 Plantation Rd Mohave Valley AZ 86440-8420 Ph: (928) 346-4679 | 1607 Plantation Rd Mohave Valley AZ 86440-8420 Ph: (928) 346-4679 |
| NPI Number | 1215253463 |
|---|---|
| Provider Enumeration Date | 04/13/2010 |
| Last Update Date | 04/13/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215253463 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Tri State Therapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9976 S Phoenix Dr, Mohave Valley, AZ 86440 Phone: 562-916-5819 |