# EDVENTURES GROUP PINON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** khadjenoury LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659690287
- **Authorized official:** MR. SIAMAK KHADJENOURY (CEO)
- **Authorized official phone:** (520) 907-6890

## Contact information

- **Practice address:** 1 MILE NORTH OF PINON NAVAJO RT HWY 41, PINON, AZ 86510
- **Practice address phone:** (520) 907-6890
- **Practice address fax:** (801) 930-9134
- **Mailing address:** 8848 WILLOW HILLS CT, SANDY, UT 84093-1889
- **Mailing address phone:** (520) 907-6890
- **Mailing address fax:** (801) 930-9134

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/21/2010
- **Last updated:** 05/21/2010