| Mohave Mental Health Clinic, Inc. | |
|
151 Riviera Dr Ste B Lake Havasu City AZ 86403-5740 | |
| (928) 855-3432 | |
| (928) 855-0103 |
| Full Name | Mohave Mental Health Clinic, Inc. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 151 Riviera Dr Ste B, Lake Havasu City, Arizona |
| Authorized Official Name and Position | Dawn D Abbott (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9287578111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mohave Mental Health Clinic, Inc. 3707 N Stockton Hill Rd Ste B Kingman AZ 86409-0507 Ph: (928) 757-8111 | Mohave Mental Health Clinic, Inc. 151 Riviera Dr Ste B Lake Havasu City AZ 86403-5740 Ph: (928) 855-3432 |
| NPI Number | 1912458589 |
|---|---|
| Provider Enumeration Date | 10/19/2016 |
| Last Update Date | 06/23/2021 |
| Certification Date | 06/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912458589 | NPI | - | NPPES |
| BH5021 | Other | AZ | ADHS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | BH5021 (Arizona) | Primary |
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