Organization
WEST YAVAPAI GUIDANCE CLINIC
Active
Organization
WEST YAVAPAI GUIDANCE CLINIC
Active
Other names
Polara Health
Organization subpart
No
Provider details
NPI number
Authorized official
KARA LANGLEY MACC (CFAO)
(928) 445-5211
Entity
Organization
Contact information
Practice address
1200 PRESCOTT LAKES PKWY BLDG B, PRESCOTT, AZ 86301-6876
(928) 445-5211
(928) 776-8484
Mailing address
3343 N WINDSONG DR, PRESCOTT VALLEY, AZ 86314-1213
(928) 445-5211
(928) 776-8484
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IFH13537
AZDH LICENSE
AZ
Enumeration date
10/02/2024
Last updated
10/02/2024
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