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791 S 4th Ave Ste A Yuma AZ 85364-3067 | |
| (928) 783-3616 | |
| (520) 207-3855 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 791 S 4th Ave Ste A, Yuma, Arizona |
| Authorized Official Name and Position | Rebecca King (COO) |
| Authorized Official Contact | 5204966310 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1200 N Country Club Rd Tucson AZ 85716-3625 Ph: (520) 770-1197 | 791 S 4th Ave Ste A Yuma AZ 85364-3067 Ph: (928) 783-3616 |
| NPI Number | 1417346701 |
|---|---|
| Provider Enumeration Date | 01/09/2015 |
| Last Update Date | 02/05/2025 |
| Certification Date | 02/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417346701 | NPI | - | NPPES |
| 006758 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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