| Smi Supportive Housing - Coconino | |
|
463 S Lake Powell Blvd Page AZ 86040-0856 | |
| (928) 645-5113 | |
| Not Available |
| Full Name | Smi Supportive Housing - Coconino |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 463 S Lake Powell Blvd, Page, Arizona |
| Authorized Official Name and Position | John Hogeboom (CEO) |
| Authorized Official Contact | 4808317566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smi Supportive Housing - Coconino 1855 W Baseline Rd Ste 101 Mesa AZ 85202-9098 Ph: (480) 831-7566 | Smi Supportive Housing - Coconino 463 S Lake Powell Blvd Page AZ 86040-0856 Ph: (928) 645-5113 |
| NPI Number | 1083593511 |
|---|---|
| Provider Enumeration Date | 08/28/2025 |
| Last Update Date | 08/28/2025 |
| Certification Date | 08/28/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083593511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | () | Primary |
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