Organization
FORT MOJAVE INDIAN TRIBE
Active
Organization
FORT MOJAVE INDIAN TRIBE
Active
Other names
FORT MOJAVE INDIAN HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM WILLIAMS (TRIBAL CHAIRPERSON)
(760) 629-4591
Entity
Organization
Contact information
Practice address
1607 PLANTATION RD, MOHAVE VALLEY, AZ 86440-9686
(928) 346-4679
(928) 346-4686
Mailing address
1607 PLANTATION RD, MOHAVE VALLEY, AZ 86440-9686
(928) 346-4679
(928) 346-4686
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0500888779
CLIA
—
05
—
890211
—
AZ
01
—
EAP00010F
EAPC
CA
Enumeration date
05/16/2006
Last updated
02/06/2023
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