=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598994584
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NAVAJO NATION OFFICE OF SPECIAL EDUCATION & REHABILITATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2009
-----------------------------------------------------
Last Update Date | 07/10/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | MORGAN BOULEVARD DINE EDUCATION CENTER ROOM 205
-----------------------------------------------------
City | WINDOW ROCK
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 86515-1420
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 928-871-6338
-----------------------------------------------------
Fax | 982-871-7865
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1420
-----------------------------------------------------
City | WINDOW ROCK
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 86515-1420
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 928-871-6338
-----------------------------------------------------
Fax | 982-871-7865
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MS. TREVA ROANHORSE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 928-871-6338
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------