Organization
HOPI HEALTH CARE CENTER
Active
Parent organization
DHHS IHS PHOENIX AREA
Organization subpart
Yes
Provider details
NPI number
Legal business name
DHHS IHS PHOENIX AREA
Authorized official
MS. THERESA ANN WILSON LCSW (CLINICAL SOCIAL WORKER)
(928) 737-6188
Entity
Organization
Contact information
Practice address
HIGHWAY 264 MILEPOST 388, POLACCA, AZ 86042-4000
(928) 737-6000
Mailing address
HIGHWAY 264 MILEPOST 388, POLACCA, AZ 86042-4000
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0698081
NY
Other
Enumeration date
05/08/2013
Last updated
05/08/2013
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