Organization
COCONINO COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH SCHILDECKER (DIVISION MANAGER)
(928) 679-7377
Entity
Organization
Contact information
Practice address
2625 N KING ST, CLINICAL SERVICES, FLAGSTAFF, AZ 86004-1884
(928) 679-7222
(928) 679-7351
Mailing address
2625 N KING ST, CLINICAL SERVICES, FLAGSTAFF, AZ 86004-1884
(928) 679-7222
(928) 679-7351
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
AP1709
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
062224
—
AZ
Enumeration date
03/26/2007
Last updated
11/03/2020
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