| Khadjenoury LLC | |
|
1 Mile North Of Pinon Navajo Rt Hwy 41 Pinon AZ 86510 | |
| (520) 907-6890 | |
| (801) 930-9134 |
| Full Name | Khadjenoury LLC |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1 Mile North Of Pinon Navajo Rt Hwy 41, Pinon, 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 1 Mile North Of Pinon Navajo Rt Hwy 41 Pinon AZ 86510 Ph: (520) 907-6890 |
| NPI Number | 1659690287 |
|---|---|
| Provider Enumeration Date | 05/21/2010 |
| Last Update Date | 05/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659690287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | () | Primary |
Pinon Health Center Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2175 State Road 4, Pinon, AZ 86510 Phone: 928-725-9500 Fax: 928-725-9540 |