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Organization
WEST YAVAPAI GUIDANCE CLINIC, INC.
Active
Organization
WEST YAVAPAI GUIDANCE CLINIC, INC.
Active
Other names
Polara Health
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA DIANE MCLAIN (CREDENTIALING SPECIALIST)
(928) 445-5211
Entity
Organization
Contact information
Practice address
625 W HILLSIDE AVE, PRESCOTT, AZ 86301-1936
(928) 445-5211
Mailing address
3343 N WINDSONG DR, PRESCOTT VALLEY, AZ 86314-1213
(928) 445-5211
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
NULL
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Enumeration date
01/14/2020
Last updated
06/14/2021
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