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General NPI Number Information
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NPI Number | 1518202100
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Entity Type | Organization
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Legal Business Name | CHANGEPOINT INTEGRATED HEALTH
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Dates
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Enumeration Date | 12/07/2012
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Last Update Date | 12/09/2016
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Provider Practice Location Address
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Address Line | 1801 W DEUCE OF CLUBS SUITE 100
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City | SHOW LOW
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State | AZ
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Zip | 85901-2705
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Country | US
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Telephone | 928-537-2951
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Fax | 928-892-5828
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Provider Business Mailing Address
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Address Line | 1801 W DEUCE OF CLUBS SUITE 100
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City | SHOW LOW
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State | AZ
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Zip | 85901-2705
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Country | US
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Telephone | 928-537-2951
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Fax | 928-892-5828
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Authorized Official
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Title or Position | CEO
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Name | JEFFREY OAKES
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Credential | MBA
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Telephone | 928-537-2951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | BH140
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License Number State | AZ
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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 | BH3321
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | BH4058
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | SH4758
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | BH806
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License Number State | AZ
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