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NPI Code Detail

MEDICARE: CHANGEPOINT INTEGRATED HEALTH

MEDICARE: CHANGEPOINT INTEGRATED HEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)OTC6041AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1003450OTHERAZAHCCCS

General Provider Information

NPI Number : 1205877610
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHANGEPOINT INTEGRATED HEALTH
Provider Business Mailing Address
First Line : 1801 W DEUCE OF CLUBS STE 100
Second Line :
City : SHOW LOW
State : AZ
Zip : 85901-2704
Country : US
Telephone Number : 928-537-2951
Fax Number : 928-892-5828
Provider Business Practice Location Address
First Line : 103 N 1ST AVE
Second Line :
City : HOLBROOK
State : AZ
Zip : 86025-2817
Country : US
Telephone Number : 928-537-2951
Fax Number : 928-892-5828
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MR. JEFFREY OAKES
Credential : MBA
Telephone Number : 928-537-2951
Provider Enumeration Date : 06/08/2006
Last Update Date : 09/04/2022

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Directions to “CHANGEPOINT INTEGRATED HEALTH ” Practice Location

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