Organization
HAVASUPAI TRIBE HEAD START
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JACQUELINE K. SIYUJA (HEALTH COORDINATOR)
(928) 448-2821
Entity
Organization
Contact information
Practice address
130 MAIN ST., SUPAI, AZ 86435-0130
(928) 448-2821
(928) 448-2341
Mailing address
PO BOX 130, SUPAI, AZ 86435-0130
(928) 448-2821
(928) 448-2341
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
172V00000X
AZ
Other
Enumeration date
06/23/2011
Last updated
06/23/2011
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