Organization
WEST YAVAPAI GUIDANCE CLINIC, INC.
Active
Parent organization
WEST YAVAPAI GUIDANCE CLINIC, INC.
Other names
Haddon House, Polara Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST YAVAPAI GUIDANCE CLINIC, INC.
Authorized official
MRS. TAMARA PLAYER (CHIEF EXECUTIVE OFFICER)
(928) 445-5211
Entity
Organization
Contact information
Practice address
711 HILLSIDE AVE, PRESCOTT, AZ 86301
(928) 445-5211
(928) 717-1204
Mailing address
642 DAMERON DR STE B, PRESCOTT, AZ 86301-2411
(928) 445-5211
(928) 717-1204
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
BH1394
AZ
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH-1394
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
692229
—
AZ
Enumeration date
05/20/2006
Last updated
09/17/2024
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