Organization
NORTHERN ARIZONA SUBSTANCE ABUSE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY ANNETTE ERHART MSW, LISAC, CCDVC, (DIRECTOR/OWNER)
(928) 773-9376
Entity
Organization
Contact information
Practice address
2101 N 4TH ST STE 215, FLAGSTAFF, AZ 86004-4200
(928) 773-9376
Mailing address
2101 N 4TH ST STE 215, FLAGSTAFF, AZ 86004-4200
(928) 773-9376
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
#BH-1634
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
597908
AHCCCS
AZ
Enumeration date
02/20/2009
Last updated
02/20/2009
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