Organization
MOHAVE MENTAL HEALTH CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN D ABBOTT MA, LPC (CHIEF EXECUTIVE OFFICER)
(928) 757-8111
Entity
Organization
Contact information
Practice address
151 RIVIERA DR STE B, LAKE HAVASU CITY, AZ 86403-5740
(928) 855-3432
(928) 855-0103
Mailing address
3707 N STOCKTON HILL RD STE B, KINGMAN, AZ 86409-0507
(928) 757-8111
(928) 757-3256
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
BH5021
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH5021
ADHS
AZ
Enumeration date
10/19/2016
Last updated
06/23/2021
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