Provider Demographics
NPI:1619928264
Name:GOVERNMENT OF GUAM DEPARTMENT OF ADMINISTRATION
Entity Type:Organization
Organization Name:GOVERNMENT OF GUAM DEPARTMENT OF ADMINISTRATION
Other - Org Name:GUAM BEHAVIORAL HEALTH AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:C
Authorized Official - Last Name:ARRIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:671-647-1946
Mailing Address - Street 1:790 GOVERNOR CARLOS G. CAMACHO ROAD
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913
Mailing Address - Country:US
Mailing Address - Phone:671-647-1901
Mailing Address - Fax:671-649-6948
Practice Address - Street 1:790 GOVERNOR CARLOS G. CAMACHO ROAD
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913
Practice Address - Country:US
Practice Address - Phone:671-647-1901
Practice Address - Fax:671-649-6948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251S00000X, 261QM0801X, 273R00000X
GU273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No273R00000XHospital UnitsPsychiatric Unit