Organization
WEST YAVAPAI GUIDANCE CLINIC, INC.
Active
Other names
Polara Health
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA DIANE MCLAIN (CREDENTIALING SPECIALIST)
(928) 445-5211
Entity
Organization
Contact information
Practice address
625 W HILLSIDE AVE, PRESCOTT, AZ 86301-1936
(928) 445-5211
Mailing address
3343 N WINDSONG DR, PRESCOTT VALLEY, AZ 86314-1213
(928) 445-5211
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Enumeration date
01/14/2020
Last updated
06/14/2021
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