Provider Demographics
NPI:1407230725
Name:HOZHONI FOUNDATION, INC.
Entity Type:Organization
Organization Name:HOZHONI FOUNDATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:LANE
Authorized Official - Last Name:ATTRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-526-7944
Mailing Address - Street 1:2133 N WALGREENS ST
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-6100
Mailing Address - Country:US
Mailing Address - Phone:928-526-7944
Mailing Address - Fax:928-526-5909
Practice Address - Street 1:2133 N WALGREENS ST
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-6100
Practice Address - Country:US
Practice Address - Phone:928-526-7944
Practice Address - Fax:928-526-5909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251C00000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services