Organization
NORTHLAND CARES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNNY MARTINEZ (EXECUTIVE DIRECTOR)
(928) 776-4612
Entity
Organization
Contact information
Practice address
3188 N WINDSONG DR STE A, PRESCOTT VALLEY, AZ 86314-1220
(928) 776-4612
(928) 771-1767
Mailing address
3188 N WINDSONG DR STE A, PRESCOTT VALLEY, AZ 86314-1220
(928) 776-4612
(928) 771-1767
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
—
—
261QM2500X
Medical Specialty Clinic/Center
Primary
1033213053
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033213053
NATIONAL PROVIDER IDENTIFIER
—
01
—
1356370571
NATIONAL PROVIDER IDENTIFIER
AZ
01
—
1598778177
NPI
—
05
—
402329
—
AZ
Enumeration date
09/11/2006
Last updated
05/16/2025
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