| Organization Name: | DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM |
| NPI Number: | 1003083551 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL D. WEAHKEE ((CEO) CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 4212 North 16th Street Phoenix Indian Medical Center Ambulatory Surgical Cent Phoenix |
| State: | AZ US |
| Postal Code: | 850165319 |
| Phone Number: | 6022631200 |
| Fax Number: | 6022631618 |
| NPI Enumeration Date: | 05/14/2008 |
| NPI Last Update Date: | 01/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |