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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