# SPECTRUM HEALTHCARE GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Verde Valley Guidance Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043623978
- **Authorized official:** CORINNE BAILEY (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (877) 634-7333

## Contact information

- **Practice address:** 651 W MINGUS AVE, COTTONWOOD, AZ 86326-4006
- **Practice address phone:** (928) 634-2236
- **Practice address fax:** (928) 634-8960
- **Mailing address:** 8 E COTTONWOOD ST, COTTONWOOD, AZ 86326-6237
- **Mailing address phone:** (877) 634-7333
- **Mailing address fax:** (866) 984-3891

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/09/2014
- **Last updated:** 07/21/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 153499 | — | AZ |