Organization
CHINLE OUTPATIENT TREATMENT CENTER
Active
Other names
Outpatient Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
MIRANDA BLATCHFORD LCSW (BEHAVIORAL HEALTH DIRECTOR)
(928) 674-2190
Entity
Organization
Contact information
Practice address
NAVAJO ROUTE 7, DUPLEX UNIT 2004, CHINLE, AZ 86503-0777
(928) 674-2190
(928) 674-2196
Mailing address
PO BOX 777, CHINLE, AZ 86503-0777
(928) 674-2190
(928) 674-2196
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
329533
AHCCCS
AZ
Enumeration date
05/09/2007
Last updated
03/10/2022
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