Healthcare Provider Details

I. General information

NPI: 1861791667
Provider Name (Legal Business Name): DHHS PHS NAIHS INSCRIPTION HOUSE HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2011
Last Update Date: 03/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HWY 98 NAVAJO ROUTE 16
SHONTO AZ
86054-7397
US

IV. Provider business mailing address

HWY 98 NAVAJO ROUTE 16
SHONTO AZ
86054-7397
US

V. Phone/Fax

Practice location:
  • Phone: 928-672-3000
  • Fax:
Mailing address:
  • Phone: 928-672-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: LINDA WHITE
Title or Position: CEO
Credential:
Phone: 928-697-4234