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General NPI Number Information
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NPI Number | 1316014459
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Entity Type | Organization
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Legal Business Name | GUIDANCE CENTER INC
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 220 W GRANT AVE
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City | WILLIAMS
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State | AZ
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Zip | 86046-2535
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Country | US
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Telephone | 928-635-4272
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Fax |
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Provider Business Mailing Address
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Address Line | 2187 N VICKEY ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86004-6121
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Country | US
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Telephone | 928-527-1899
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Fax | 928-447-3779
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Authorized Official
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Title or Position | CEO
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Name | MRS. DEVON FORREST
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Credential |
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Telephone | 928-527-1899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | OTC6139
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License Number State | AZ
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