Ruth Street Clinic

LBN: West Yavapai Guidance Clinic, Inc.
Ruth Street Clinic is an health care organization with primary practice located at 726 Gail Gardner Way , Prescott AZ 86305-2314. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center). Ambulatory Health Care Facilities / Clinic/Center is the primary health care specialty. West Yavapai Guidance Clinic, Inc. can be contacted via phone (928) 445-5211, or through Player, Tamara via phone (928) 445-5211.

Contact Information

Primary practice address
726 Gail Gardner Way Prescott AZ 86305-2314
Phone: (928) 445-5211
Fax: (928) 776-8484
Website:
Map and Directions
Authorized official contact:
Name: Player, Tamara
Phone: (928) 445-5211

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X BH1809 Arizona
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X OTC6571 Arizona

Profile Details

NPI number 1578517108
LBN Legal business name West Yavapai Guidance Clinic, Inc.
DBA Doing business as Ruth Street Clinic
Authorized official Player, Tamara
Entity Organization
Organization subpart 1 No
Enumeration date May 19th, 2006
Last updated Jul 10th, 2024 - about last year

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 1578517108 NPPES
Arizona MEDICAID OTC13436

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