Organization
NORTHERN ARIZONA SUBSTANCE ABUSE SERVICES
Active
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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