Healthcare Provider Details

I. General information

NPI: 1639044647
Provider Name (Legal Business Name): COMPLETE JOY INTEGRATED HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2404 N STOCKTON HILL RD STE A
KINGMAN AZ
86401-4184
US

IV. Provider business mailing address

2404 N STOCKTON HILL RD STE A
KINGMAN AZ
86401-4184
US

V. Phone/Fax

Practice location:
  • Phone: 928-418-0936
  • Fax:
Mailing address:
  • Phone: 928-418-0936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. NICOLE FARNEY
Title or Position: ADMINISTRATOR
Credential:
Phone: 623-200-3267