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General NPI Number Information
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NPI Number | 1932200870
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Entity Type | Organization
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Legal Business Name | APACHE BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | 249 W PONDEROSA
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City | WHITERIVER
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State | AZ
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Zip | 85941
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Country | US
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Telephone | 928-338-4811
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Fax | 928-338-4930
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Provider Business Mailing Address
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Address Line | PO BOX 1089
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City | WHITERIVER
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State | AZ
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Zip | 85941-1089
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Country | US
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Telephone | 928-338-4811
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Fax | 928-338-4930
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | RYAN ELIZABETH JOHNSON
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Credential | LMFT
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Telephone | 928-338-4811
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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 |
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License Number State |
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