Eagledancer Youth And Family Services, Inc.

LBN: Eagledancer Youth And Family Services, Inc.
Eagledancer Youth And Family Services, Inc. is an health care organization with primary practice located at 305 West Ben Gay , White River AZ 85941. The organization recently has 3 registered licenses in different health care specialties including Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, Residential Treatment Facilities / Substance Abuse Rehabilitation Facility. Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children is the primary health care specialty. Eagledancer Youth And Family Services, Inc. can be contacted via phone (928) 338-2312, or through Hatch, Charla C via phone (928) 229-0560.

Contact Information

Primary practice address
305 West Ben Gay White River AZ 85941
Phone: (928) 338-2312
Fax: (928) 338-2313
Website:
Map and Directions
Authorized official contact:
Name: Hatch, Charla C
Phone: (928) 229-0560

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X Arizona
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X Arizona
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X Arizona

Profile Details

NPI number 1730375668
LBN Legal business name Eagledancer Youth And Family Services, Inc.
DBA Doing business as
Authorized official Hatch, Charla C
Entity Organization
Organization subpart 1 No
Enumeration date Sep 25th, 2007
Last updated Mar 15th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730375668 NPPES
Arizona MEDICAID 263967

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