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General NPI Number Information
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NPI Number | 1366040818
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Entity Type | Organization
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Legal Business Name | NAVAJO REGIONAL BEHAVIORAL HEALTH CENTER - ADULT RESIDENTIAL TREATMENT
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Dates
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Enumeration Date | 10/15/2020
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Last Update Date | 03/10/2022
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Provider Practice Location Address
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Address Line | PINON & COTTONWOOD DR BUILDING #2301
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City | SHIPROCK
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State | NM
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Zip | 87420
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Country | US
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Telephone | 505-368-1438
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Fax | 505-368-1461
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Provider Business Mailing Address
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Address Line | PO BOX 1830
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City | SHIPROCK
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State | NM
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Zip | 87420-1830
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Country | US
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Telephone | 505-368-1438
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Fax | 505-368-1461
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Authorized Official
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Title or Position | BEHAVIORAL HEALTH DIRECTOR
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Name | DR. SIDNEY BROWN
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Credential | PSY D.
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Telephone | 505-368-1438
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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