Healthcare Provider Details

I. General information

NPI: 1811065600
Provider Name (Legal Business Name): GUIDANCE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2695 E INDUSTRIAL DR
FLAGSTAFF AZ
86004
US

IV. Provider business mailing address

2187 N VICKEY ST
FLAGSTAFF AZ
86004-6106
US

V. Phone/Fax

Practice location:
  • Phone: 928-714-6450
  • Fax: 928-527-1319
Mailing address:
  • Phone: 928-527-1899
  • Fax: 928-447-3779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberBH-2845
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEVON FORREST
Title or Position: CEO
Credential:
Phone: 928-527-1899