# DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DHEW IND HLTH SVS HLTH SVS & MNTL HLTH ADM
- **Other names:** Gila Bend Clinic Professional Services
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1831245661
- **Legal business name:** DHEW IND HLTH SVS HLTH SVS & MNTL HLTH ADM
- **Authorized official:** MISS DEANNA J. DICK MSW., MHA. ((CEO) CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (602) 263-1567

## Contact information

- **Practice address:** 100 NORTH GILA BOULEVARD, GILA BEND, AZ 85227-2658
- **Practice address phone:** (602) 263-1200
- **Practice address fax:** (602) 263-1618
- **Mailing address:** PO BOX 31001-0698, PASADENA, CA 91110-0698
- **Mailing address phone:** (602) 263-1200
- **Mailing address fax:** (602) 263-1618

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 367A00000X | Advanced Practice Midwife | — | NULL | — |
| 367A00000X | Advanced Practice Midwife | — | — | — |

## Other

- **Enumeration date:** 01/26/2007
- **Last updated:** 06/19/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 812851 | — | AZ |