Organization
NORTH COUNTRY HEALTHCARE, INC.
Active
Organization
NORTH COUNTRY HEALTHCARE, INC.
Active
Parent organization
NORTH COUNTRY HEALTHCARE, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTH COUNTRY HEALTHCARE, INC.
Authorized official
ANNE M NEWLAND (CEO)
(928) 522-9400
Entity
Organization
Contact information
Practice address
2090 N. SMOKETREE AVE, LAKE HAVASU CITY, AZ 86403
(928) 854-1800
(928) 854-1818
Mailing address
PO BOX 3630, FLAGSTAFF, AZ 86003-3630
(928) 522-9400
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433079
—
AZ
Enumeration date
02/25/2009
Last updated
06/30/2021
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