MEDICARE: NAVAJO TREATMENT CENTER FOR CHILDREN AND THEIR FAMILIES

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
1	261QM0855X	Adolescent and Children Mental Health Clinic/Center	I3774	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831363175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAVAJO TREATMENT CENTER FOR CHILDREN AND THEIR FAMILIES

Provider Business Mailing Address
First Line	:	PO BOX 1967
Second Line	:
City	:	WINDOW ROCK
State	:	AZ
Zip	:	86515-1967
Country	:	US
Telephone Number	:	928-871-7673
Fax Number	:

Provider Business Practice Location Address
First Line	:	48 WEST HIGHWAY 264
Second Line	:	SUITE 244
City	:	WINDOW ROCK
State	:	AZ
Zip	:	86515
Country	:	US
Telephone Number	:	928-871-7673
Fax Number	:	928-871-6176

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	MS. MARGARET SCHILDT
Credential	:	LISW/LADAC
Telephone Number	:	928-871-6818

Provider Enumeration Date	:	04/17/2008
Last Update Date	:	04/17/2008

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