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General NPI Number Information
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NPI Number | 1922455013
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Entity Type | Organization
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Legal Business Name | HOPI HEALTH CARE CENTER
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Dates
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Enumeration Date | 05/18/2016
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Last Update Date | 05/18/2016
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Provider Practice Location Address
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Address Line | HWY 264 MP 388
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City | POLACCA
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State | AZ
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Zip | 86042
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Country | US
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Telephone | 928-737-8000
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Fax |
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Provider Business Mailing Address
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Address Line | HWY 264 MILEPOST 388
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City | POLACCA
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State | AZ
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Zip | 86042
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Country | US
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Telephone | 928-737-8000
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Fax |
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Authorized Official
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Title or Position | RN ASCN
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Name | MS. SUSAN J DEYOE
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Credential |
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Telephone | 928-737-6372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | RN189558
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License Number State | AZ
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