Organization
WEST YAVAPAI GUIDANCE CLINIC, INC.
Active
Parent organization
WEST YAVAPAI GUIDANCE CLINIC, INC.
Other names
West Yavapai Primary Care, Polara Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST YAVAPAI GUIDANCE CLINIC, INC.
Authorized official
TAMARA K. PLAYER (CEO)
(928) 445-5211
Entity
Organization
Contact information
Practice address
3345 N WINDSONG DR, ATTN: TINA TOLLIVER, SUITE B, PRESCOTT VALLEY, AZ 86314-2283
(928) 583-6411
(928) 776-8031
Mailing address
3343 N. WINDSONG DR., PRESCOTT VALLEY, AZ 86314-2283
(928) 445-5211
(928) 776-8031
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
OTC 5318
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTC 5318
ADHS MEDICAL LICENSE
AZ
Enumeration date
03/13/2012
Last updated
06/14/2021
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