| Sequel Tsi Of Az, Llc | |
|
75 S. Main St., Suite B Kentucky Fried Chicken Comples Tuba City AZ 86045 | |
| (928) 283-6808 | |
| (928) 283-6848 |
| Full Name | Sequel Tsi Of Az, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 75 S. Main St., Suite B, Tuba City, Arizona |
| Authorized Official Name and Position | Chris Banken (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6023352095 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sequel Tsi Of Az, Llc Po Box 2257 Tuba City AZ 86045-2257 Ph: (928) 283-6808 | Sequel Tsi Of Az, Llc 75 S. Main St., Suite B Kentucky Fried Chicken Comples Tuba City AZ 86045 Ph: (928) 283-6808 |
| NPI Number | 1790015428 |
|---|---|
| Provider Enumeration Date | 12/31/2009 |
| Last Update Date | 12/31/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790015428 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
Tuba City Outpatient Treatment Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: Main Street Bldg. 25, Tuba City, AZ 86045 Phone: 928-283-3346 Fax: 928-283-3039 | |
Vista Care, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2027 N Spruce Street, Tuba City, AZ 86045 Phone: 928-283-6308 Fax: 928-283-6848 |