Organization Name: | MOHAVE MENTAL HEALTH CLINIC INC |
NPI Number: | 1861562423 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAWN D ABBOTT (CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 1080 Sheldon Ave Kingman |
State: | AZ US |
Postal Code: | 86409 |
Phone Number: | 9287578111 |
Fax Number: | 9287573256 |
NPI Enumeration Date: | 11/09/2006 |
NPI Last Update Date: | 08/03/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | BH647 AZ DOHS |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |