Organization
DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM
Active
Parent organization
DHEW IND HLTH SV HLTH SVS &M MNTL HLTH ADM
Other names
YAHC Professional Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
DHEW IND HLTH SV HLTH SVS &M MNTL HLTH ADM
Authorized official
MISS DEANNA J. DICK MSW., MHA. ((CEO) CHIEF EXECUTIVE OFFICER)
(602) 263-1567
Entity
Organization
Contact information
Practice address
2121 WEST RESERVATION LOOP ROAD, CAMP VERDE, AZ 86322
(602) 263-1200
(602) 263-1618
Mailing address
PO BOX 31001-0698, PASADENA, CA 91110-0698
(602) 263-1200
(602) 263-1618
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
133V00000X
Registered Dietitian
—
—
152W00000X
Optometrist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
231H00000X
Audiologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
812869
—
AZ
Enumeration date
01/25/2007
Last updated
06/18/2019
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