| Aj Adult With Serious Mental Illness Program | |
|
11518 E Apache Trl #129 Apache Junction AZ 85120-3551 | |
| (480) 784-1514 | |
| (480) 967-3528 |
| Full Name | Aj Adult With Serious Mental Illness Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 11518 E Apache Trl, Apache Junction, Arizona |
| Authorized Official Name and Position | Laura Larson-huffacker (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4807841514 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aj Adult With Serious Mental Illness Program 618 S Madison Dr Tempe AZ 85281-7248 Ph: (480) 784-1514 | Aj Adult With Serious Mental Illness Program 11518 E Apache Trl #129 Apache Junction AZ 85120-3551 Ph: (480) 784-1514 |
| NPI Number | 1114462306 |
|---|---|
| Provider Enumeration Date | 12/27/2016 |
| Last Update Date | 12/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114462306 | NPI | - | NPPES |
| 183711 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | OTC7842-5DUT11 (Arizona) | Primary |
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