Organization
DHHS IHS PHOENIX AREA
Active
Parent organization
DHHS IHS PHOENIX AREA
Other names
Cibecue
Organization subpart
Yes
Provider details
NPI number
Legal business name
DHHS IHS PHOENIX AREA
Authorized official
MICHELLE MARTINEZ FNP (CHIEF EXECUTIVE OFFICER)
(928) 338-4911
Entity
Organization
Contact information
Practice address
NORTH CROMWELL ROAD, CIBECUE, AZ 85911
(928) 332-2560
(928) 338-5508
Mailing address
P.O. BOX 860, 200 HOSPITAL DRIVE, WHITERIVER, AZ 85941-0860
(928) 338-4911
(928) 338-5508
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092461
—
AZ
Enumeration date
09/29/2008
Last updated
03/27/2012
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