Organization
SPECTRUM HEALTHCARE GROUP, INC
Active
Other names
Verde Valley Guidance Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CORINNE BAILEY (CREDENTIALING SPECIALIST)
(877) 634-7333
Entity
Organization
Contact information
Practice address
651 W MINGUS AVE, COTTONWOOD, AZ 86326-4006
(928) 634-2236
(928) 634-8960
Mailing address
8 E COTTONWOOD ST, COTTONWOOD, AZ 86326-6237
(877) 634-7333
(866) 984-3891
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153499
—
AZ
Enumeration date
06/09/2014
Last updated
07/21/2021
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