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Hwy 394.3 Us-160 Kayenta AZ 86033-0487 | |
| (928) 697-5570 | |
| (928) 697-5574 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | Hwy 394.3 Us-160, Kayenta, Arizona |
| Authorized Official Name and Position | Miranda Blatchford (BEHAVIORAL HEALTH DIRECTOR) |
| Authorized Official Contact | 9286975570 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 487 Kayenta AZ 86033-0487 Ph: (928) 697-5570 | Hwy 394.3 Us-160 Kayenta AZ 86033-0487 Ph: (928) 697-5570 |
| NPI Number | 1811109762 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 03/10/2022 |
| Certification Date | 03/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811109762 | NPI | - | NPPES |
| 329559 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 305S00000X | Point Of Service | (* (Not Available)) | Secondary |