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03D0865809 CLIA NUMBER - HUALAPAI HEALTH DEPT WIC/CHR PROGRAM/HEALTHY HEART

Laboratory Demographics

CLIA Number: 03D0865809

Facility Name: HUALAPAI HEALTH DEPT WIC/CHR PROGRAM/HEALTHY HEART

Facility Address:
488 HUALAPAI WAY
PEACH SPRINGS, AZ
ZIP 86434
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Facility Phone Number: 928 769-2207

Facility Type: Other

Certificate Type: Waiver
NPI Number: 1568636116

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name Field Value
CLIA Number 03D0865809
LAB Type Other
Facility Name HUALAPAI HEALTH DEPT WIC/CHR PROGRAM/HEALTHY HEART
Street 488 HUALAPAI WAY
City PEACH SPRINGS
State AZ
ZIP 86434
Phone 928 769-2207
CertificateType 4
CertificateEffectiveDate 9/1/2022
CertificateExpirationDate 8/31/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024