| Pine View Behavioral Health Center | |
|
2550 Show Low Lake Road Show Low AZ 85901-7929 | |
| (928) 537-1029 | |
| (928) 537-9049 |
| Full Name | Pine View Behavioral Health Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2550 Show Low Lake Road, Show Low, Arizona |
| Authorized Official Name and Position | Ivan Robert Wilderman (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9285246701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine View Behavioral Health Center 2550 Show Low Lake Road Show Low AZ 85901-7929 Ph: (928) 537-1029 | Pine View Behavioral Health Center 2550 Show Low Lake Road Show Low AZ 85901-7929 Ph: (928) 537-1029 |
| NPI Number | 1487679973 |
|---|---|
| Provider Enumeration Date | 07/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487679973 | NPI | - | NPPES |
| 590142 | Other | AZ | AHCCCS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Community Medical Services-show Low Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 E Woolford Rd Ste 101, Show Low, AZ 85901 Phone: 928-251-2030 Fax: 928-892-5103 | |
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Summit Healthcare Association Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2200 E Show Low Lake Rd, Show Low, AZ 85901 Phone: 928-537-6393 Fax: 928-532-2131 | |
Changepoint Integrated Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1801 W Deuce Of Clubs, Suite 100, Show Low, AZ 85901 Phone: 928-537-2951 Fax: 928-892-5828 | |
Tlc Supported Living Services Of Az, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2500 E Cooley St, Suite 401, Show Low, AZ 85901 Phone: 928-537-9744 Fax: 928-537-5188 |