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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