Organization
KAYENTA OUTPATIENT TREATMENT CENTER
Active
Other names
Kayenta Outpatient Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
MIRANDA BLATCHFORD LCSW (BEHAVIORAL HEALTH DIRECTOR)
(928) 697-5570
Entity
Organization
Contact information
Practice address
HWY 394.3 US-160, KAYENTA, AZ 86033-0487
(928) 697-5570
(928) 697-5574
Mailing address
PO BOX 487, KAYENTA, AZ 86033-0487
(928) 697-5570
(928) 697-5574
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
305S00000X
Point of Service
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
329559
—
AZ
Enumeration date
05/04/2007
Last updated
03/10/2022
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