| Khadjenoury Llc | |
|
State Hwy 191 Lake View Dr Edventures Program C/o Many Farms High School Many Farms AZ 86538 | |
| (520) 907-6890 | |
| Not Available |
| Full Name | Khadjenoury Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | State Hwy 191 Lake View Dr, Many Farms, Arizona |
| Authorized Official Name and Position | Siamak Khadjenoury (CEO) |
| Authorized Official Contact | 5209076890 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Khadjenoury Llc 8848 Willow Hills Ct Sandy UT 84093-1889 Ph: (520) 907-6890 | Khadjenoury Llc State Hwy 191 Lake View Dr Edventures Program C/o Many Farms High School Many Farms AZ 86538 Ph: (520) 907-6890 |
| NPI Number | 1972772465 |
|---|---|
| Provider Enumeration Date | 02/28/2008 |
| Last Update Date | 02/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972772465 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Khadjenoury Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: State Hwy 191 Lakeview Dr, Edventures Program C/o Chinle Boarding School, Many Farms, AZ 86538 Phone: 520-907-6890 |