Organization
PHOENIX INDIAN CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA HIBBELER MA (CHIEF EXECUTIVE OFFICER)
(602) 264-6768
Entity
Organization
Contact information
Practice address
4520 N CENTRAL AVE, SUITE 250, PHOENIX, AZ 85012-1828
(602) 264-6768
(602) 274-7486
Mailing address
4520 N CENTRAL AVE, SUITE 250, PHOENIX, AZ 85012-1828
(602) 264-6768
(602) 274-7486
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH138
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
740367
—
AZ
Enumeration date
02/06/2007
Last updated
08/22/2020
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