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Highway 163 Kayenta Mobile Home Park #8 Kayenta AZ 86033 | |
(928) 697-3154 | |
(928) 697-3156 |
Full Name | |
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Speciality | Clinic/center - Adult Mental Health |
Location | Highway 163, Kayenta, Arizona |
Authorized Official Name and Position | Chris Banken (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 6023352095 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Highway 163 Kayenta Mobile Home Park #8 Kayenta AZ 86033 Ph: (928) 697-3154 | Highway 163 Kayenta Mobile Home Park #8 Kayenta AZ 86033 Ph: (928) 697-3154 |
NPI Number | 1982934618 |
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Provider Enumeration Date | 12/31/2009 |
Last Update Date | 12/31/2009 |
Identifier | Type | State | Issuer |
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1982934618 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |