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Organization

MT GRAHAM REGIONAL MEDICAL CENTER INC

Active
Parent organization
MT GRAHAM REGIONAL MEDICAL CENTER INC
Other names
Mt Graham Home Health
Organization subpart
Yes

Provider details

NPI number
Legal business name
MT GRAHAM REGIONAL MEDICAL CENTER INC
Authorized official
MRS. JILL DENICE HEINRICH RN, BSN (ADMINISTRATOR)
(928) 428-5668
Entity
Organization

Contact information

Practice address
1600 S. 20TH AVE., BLDG. E, SAFFORD, AZ 85546
(928) 428-5668
(928) 348-3868
Mailing address
1600 S. 20TH AVE., BLDG. E, SAFFORD, AZ 85546
(928) 428-5668
(928) 348-3868

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HHA-210
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03D0886073
CLIA NUMBER
AZ
05
317786
AZ
01
HHA-210
ADHS NUMBER
AZ
Enumeration date
04/25/2006
Last updated
04/26/2012
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