Organization Name: | MOHAVE HEALTHCARE, INC. |
NPI Number: | 1629452768 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN GOCHNOUR (VICE PRESIDENT) |
Mailing Address: | 3003 Highway 95 Suite 27 Bullhead City |
State: | AZ US |
Postal Code: | 864427896 |
Phone Number: | 9286834041 |
Fax Number: | 5203333068 |
NPI Enumeration Date: | 07/18/2015 |
NPI Last Update Date: | 10/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |