Organization
LITTLE COLORADO BEHAVIORAL HEALTH CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN HOGEBOOM (CEO)
(480) 831-7566
Entity
Organization
Contact information
Practice address
470 W CLEVELAND ST, SAINT JOHNS, AZ 85936-4501
(928) 337-4301
(928) 337-2269
Mailing address
PO BOX 579, SAINT JOHNS, AZ 85936-0579
(928) 337-4301
(928) 337-2269
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003442
—
AZ
Enumeration date
11/16/2006
Last updated
09/18/2024
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