Provider Demographics
NPI:1346433273
Name:THE GUIDANCE CENTER, INC
Entity Type:Organization
Organization Name:THE GUIDANCE CENTER, INC
Other - Org Name:BHRF-VSO
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEVON
Authorized Official - Middle Name:
Authorized Official - Last Name:FORREST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-527-1899
Mailing Address - Street 1:2187 N VICKEY ST
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-6106
Mailing Address - Country:US
Mailing Address - Phone:928-527-1899
Mailing Address - Fax:928-714-6480
Practice Address - Street 1:2187 N VICKEY ST
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-6106
Practice Address - Country:US
Practice Address - Phone:928-527-1899
Practice Address - Fax:928-714-6480
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BHRF-VSO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-23
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
320800000X, 320800000X
AZBH4886324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZBH4886OtherADHS LINCENSE
AZ154902Medicaid