| Pinetop Treatment Center Llc | |
|
674 E White Mountain Blvd Suite 1 Pinetop AZ 85935-8503 | |
| (602) 516-4473 | |
| Not Available |
| Full Name | Pinetop Treatment Center Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 674 E White Mountain Blvd Suite 1, Pinetop, Arizona |
| Authorized Official Name and Position | Habtom H Hadish (MANAGER) |
| Authorized Official Contact | 6025164473 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pinetop Treatment Center Llc Po Box 2310 Pinetop AZ 85935-2310 Ph: (602) 516-4473 | Pinetop Treatment Center Llc 674 E White Mountain Blvd Suite 1 Pinetop AZ 85935-8503 Ph: (602) 516-4473 |
| NPI Number | 1568158301 |
|---|---|
| Provider Enumeration Date | 04/14/2023 |
| Last Update Date | 04/14/2023 |
| Certification Date | 04/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568158301 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Pinetop Behavioral Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 674 E White Mountain Blvd # 5, Blvd 5, Pinetop, AZ 85935 Phone: 207-409-6515 |