Organization
SAN CARLOS APACHE TRIBE
Active
Parent organization
SAN CARLOS APACHE TRIBE
Other names
Wellness Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAN CARLOS APACHE TRIBE
Authorized official
MR. WENDSLER A NOSIE SR. (TRIBAL CHAIRMAN)
(928) 475-2361
Entity
Organization
Contact information
Practice address
#5 SAN CARLOS AVE, SAN CARLOS, AZ 85550-9999
(928) 475-4875
(928) 475-4880
Mailing address
PO BOX 0, SAN CARLOS, AZ 85550-9999
(928) 475-4875
(928) 475-4880
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
180-004505
IL
251S00000X
Community/Behavioral Health Agency
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
624230
—
AZ
Enumeration date
11/21/2006
Last updated
07/01/2009
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