| Patchwork Hope Llc | |
|
409 N Cottonwood Ave Winslow AZ 86047-4017 | |
| (928) 587-5462 | |
| Not Available |
| Full Name | Patchwork Hope Llc |
|---|---|
| Speciality | Counselor |
| Location | 409 N Cottonwood Ave, Winslow, Arizona |
| Authorized Official Name and Position | Brenda Faye Manthei (OWNER) |
| Authorized Official Contact | 9285875462 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Patchwork Hope Llc 409 N Cottonwood Ave Winslow AZ 86047-4017 Ph: (928) 587-5462 | Patchwork Hope Llc 409 N Cottonwood Ave Winslow AZ 86047-4017 Ph: (928) 587-5462 |
| NPI Number | 1205601564 |
|---|---|
| Provider Enumeration Date | 11/16/2023 |
| Last Update Date | 11/16/2023 |
| Certification Date | 11/16/2023 |
| Medicare PECOS PAC ID | 9931540309 |
|---|---|
| Medicare Enrollment ID | O20240516000709 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205601564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Brenda Faye Manthei |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104473610 PECOS PAC ID: 0840631214 Enrollment ID: I20240516000906 |
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