Organization
HIGH COUNTRY EARLY INTERVENTION INC
Active
Other names
Karen Ann Fay
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ANNA M MANCHA (EXECUTIVE DIRECTOR)
(928) 776-9285
Entity
Organization
Contact information
Practice address
3105 CLEARWATER DR, SUITE B, PRESCOTT, AZ 86305-7166
(928) 776-9285
(928) 776-7753
Mailing address
3160 STILLWATER DR STE B, PRESCOTT, AZ 86305-7151
(928) 776-4349
(928) 776-1369
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
3724
AZ
174400000X
Specialist
4192
AZ
225100000X
Physical Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
3724
AZ
252Y00000X
Early Intervention Provider Agency
4192
AZ
261QD1600X
Developmental Disabilities Clinic/Center
4192
AZ
261QP2000X
Physical Therapy Clinic/Center
5331
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
940454
—
AZ
Enumeration date
08/31/2006
Last updated
10/08/2019
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